Vermont's Rural Health Transformation Plan - Sub-Recipients/Sub-Awardees: More information on subrecipients and sub-awardees for all projects within each initiative will be provided to CMS at a later date following completion of state procurement processes. Sub-recipients and awardees will include health care providers (e.g., hospitals, federally qualified health centers, primary care clinics, etc.), housing developers, workforce training and clinical residency programs, among others. The state will also procure consultants and contractors to implement various projects as well as an independent evaluator to assess the outcomes of the state’s RHT Program according to defined metrics. Total Budget Amount: $200 million per budget year. Project Goals and Description of Funding Uses: The Vermont RHT Program seeks to advance a cohesive suite of health care innovations and reforms that address the state's rural health care access, quality, and affordability challenges. The Program is designed to ensure long-term health care system sustainability in the face of rising costs and population health needs, workforce and housing shortages, and other challenges. Vermont’s RHT Program goals are to: (1) strengthen the state’s rural health care workforce; (2) increase access to timely care across rural communities; and (3) expand innovative strategies to increase quality and reduce health care costs. Funds will be allocated across five core initiatives: • Regionalization and Innovative Care Strategies: Absent regionalizing services, reducing business efficiencies, and modernizing the system of care, it is likely that over the next 5 years Vermont will see significant erosion of health and social services. To address this challenge, the state will implement a statewide transformation planning initiative to ensure that Vermonters can access the right care, at the right time, at the right place, and at an affordable cost. The state’s vision is that certain essential services are available in local communities, while other services are in either regional hubs around the state or, for the most complex care, a single location statewide. Regionalization protects access to care over the long term by ensuring non-duplication of services and redirection of resources to high-value, essential services. • Establishing a Clinically Integrated Network of Shared Services: The state will foster collaboration and partnerships across the continuum of independent providers in the state to produce operational efficiencies that facilitate patient choice and market competition. The state also seeks to promote adoption of patient-facing technologies that facilitate delivery of care closer to home. • Strengthening Primary Care: The state will enhance its outdated, foundational primary care reform initiative, Blueprint for Health, to improve team-based chronic disease care, deliver workforce training, provide transformation assistance to primary care practices, and create a statewide quality improvement and learning network. • Health Care Workforce Development: To address significant provider shortages, the state will make strategic investments in workforce programs that strengthen its rural health care workforce pipeline, while simultaneously addressing housing shortages. The state will also invest in enabling providers to practice at the top of their license. • Price Transparency and Insurance Competition: The state aims to address rising health care costs and affordability barriers through investments in new accountability tools and strategies.
