Vermont’s State Office of Rural Health & Primary Care (SORH/PC) is applying for $117,099 to support the work of up to eight (8) critical access hospitals (CAHs) and one (1) small rural prospective payment system (PPS) hospital serving our state, for a total of nine (9) SHIP-eligible hospitals. An additional four rural PPS acute care hospitals, two academic medical centers, two psychiatric hospitals and one Veterans Affairs hospital serve Vermont’s 643,500 residents. Most are independent, and all are non-profit and accept any patient regardless of insurance status or ability to pay for services. The overall goal for 2023-28 continues to be to prepare Vermont’s SHIP-eligible hospitals for full participation in Vermont’s single statewide Accountable Care Organization (ACO) within our All-Payer Model reimbursement environment. All 14 Vermont hospitals are currently members the ACO, OneCare Vermont, as well as all 10 Designated MH Agencies, nine of 11 FQHCs, 21 Skilled Nursing Facilities, all 10 Home Health Agencies, and 120 of about 210 total Primary Care practices. Most Vermont hospitals are facing similar challenges: caring for an older than average population, mental health crises in the emergency department, increasing substance use disorders and other chronic conditions, administrative burden for reporting quality measures required by the State, CMS, MBQIP and ACO population health measures. In addition, recovery from the COVID 19 pandemic has increased stress, burnout, vacancies, and turnover of workforce at all levels and departments. All nine Vermont SHIP-eligible hospitals implemented ICD-10 coding by 2015 and have not yet planned for ICD-11 implementation. All VT hospitals have reported HCAHPS measures for more than 14 years as required by Vermont statute, called Act 53. Therefore, Vermont’s SHIP-eligible hospitals have again identified several activities from the SHIP Allowable Investment categories to support their move toward
Value-based purchasing (VBP) and/or participation in OneCare Vermont, the statewide Accountable Care Organization (ACO). No hospitals have indicated interest in Bundled Payment (BP)/PPS activities. Specifically, over the next several years, Vermont’s SHIP-eligible hospitals will be using SHIP funds to support 1) HCAHPS data collection, 2) data collection of other MBQIP measures, 3) efficiency or quality improvement training/processes, 4) population health and 5) systems performance preparation for ACO participation. Hospitals will also be preparing for ICD-11 implementation and health equity training of all workforce. To support this work Vermont’s SORH/PC will distribute up to $13,011 to each of nine participating SHIP-eligible hospitals. Staff time for the SHIP Coordinator will be supported by the Flex and SORH grants, so 100% of SHIP funds will be available to hospitals.