Benefits - OneCare Vermont

Patient Benefits

OneCare Vermont is focused on improved health, higher quality, lower cost increases and greater coordination of care for our Medicare beneficiaries. Read the frequently asked questions below to learn more about OneCare Vermont and what it will do for you as a Medicare beneficiary.


What’s an Accountable Care Organization (ACO)?

An ACO is a group of health care providers who have agreed to share responsibility for the quality and cost of care for a specific group of patients, with the goal of improving their overall health. This effort is part of the ongoing commitment by hospitals and providers to find new ways to enhance quality of patient care, improve communication between patients and providers, ensure providers work together in a more coordinated way, and lower the rate of health care spending. If providers in an ACO are successful, they may share in possible savings generated from providing better coordinated, high-quality care to their patients. Learn more about ACOs by watching the video at the bottom of this page.

What is OneCare Vermont?

OneCare Vermont is an extensive network of health care providers, including all 14 Vermont’s hospitals, Dartmouth-Hitchcock of New Hampshire, hundreds of primary care physicians and specialists, two federally qualified health centers, and several rural health clinics. The participants in this network have agreed to work together to care for a significant number of Vermont’s Medicare beneficiaries

Is my physician a OneCare Vermont participant? 

To see if your provider’s practice or hospital participates in OneCare Vermont, see the network participant list.

How will OneCare Vermont benefit me?

We hope that the only change you and your family see is better service and better care from the health care system, with better health for you. OneCare Vermont is about improved health, higher quality, lower costs and greater coordination of care for you. 

Health:

Our number one focus as providers is to focus on keeping you healthy - meaning that illness prevention, chronic care management, and overall wellness will be our top priority.

Quality:

We’ll be working together as providers to assure that each of us are delivering the safest, most high-quality care to our patients.

Cost:

Because we’re focusing on better coordination with each other as providers, and in keeping our patients as healthy as possible, we will provide the right care, at the right time, in the right place to each of our patients. This will help us lower the rate of growth in health care costs.

Coordination and Communication:

Our providers will be coordinating their efforts with one another, meaning that you won’t be subjected to unnecessary, repetitive tests and procedures. We’ll also be improving how we communicate with each other and how we use patient health data to make more informed decisions about your care.

How will my Medicare benefits change if my primary care doctor is a OneCare Vermont participant?

Your benefits will not change with this new program. Your health coverage, premiums and insurance arrangements will not be affected. You do not need to change your doctor, and you may continue to see the same clinicians as you normally do. You should know that an ACO is not a Medicare Advantage plan, and it is not “managed care” (an HMO). You are always free to choose any doctor or hospital who accepts Medicare at any time – regardless of whether they are a member of OneCare Vermont.

Do I need to sign up for OneCare Vermont?

You do not need to do anything!

How does this impact my prescription drugs? 

Your prescription drug benefits will not be affected by OneCare Vermont. If you have Medicare Part D, for example, that is still in effect. If you have questions about specific medications, please speak with your physician.

What does this mean for my supplemental plan through another insurance provider?

There will be no impact to your insurance plans from OneCare Vermont. OneCare Vermont is not a health insurance plan. 

I see both a primary care physician and another specialist, who isn’t in the OneCare Vermont network – or, I winter in another state and see a different provider while I am away from Vermont.  What does this mean to me? 

There will be no impact to you as a patient – you are free to see any provider you choose, regardless of whether or not they are a OneCare Vermont participant. Your providers will continue to communicate with each other as they always have done regarding your care.

I still have questions about OneCare Vermont.  Who can I contact for more information?

Feel free to submit your question online to OneCare Vermont or call us at 802-847-7220 or toll free at 877-644-7176.

Please visit www.medicare.gov/acos.html or call 1-800-MEDICARE (1-800-633-4227 (TTY users should call 1-877-486-2048)) for general questions or additional information about Accountable Care Organizations.

Video: More Information About Accountable Care Organizations

Watch the following video produced by the Centers for Medicare and Medicaid Services (CMS). Please note that OneCare Vermont is not part of the Pioneer ACO Model, it is part of the Medicare Shared Savings Program. This video is being shared for reference only.