Roper: OneCare Vermont – scrap it now

By Rob Roper

Rob Roper is the president of the Ethan Allen Institute.

After the epic failure of Peter Shumlin’s single payer healthcare scheme in 2014, the next big “reform” that took its place was OneCare, launch date 2016. Many saw this as a backdoor approach to single payer, replacing the single payer with a single provider working within a “global budget,” a set dollar amount per patient not to be exceeded. The promises accompanying OneCare, as with pretty much every promise by government, were that it would lower costs, increase efficiency, and lead to healthier outcomes for participants.

The main idea behind the program is to pay providers a fixed amount per patient, eliminating the “fee for service” model of payment, therefore incentivizing providers to keep patients healthy in the first place, replacing more expensive treatments with less expensive preventative care. The results are coming in, and — shock! — the program has not lived up to expectations.

Cost-wise, the original budget for OneCare was $620.8 million to cover 122,000 guinea pi—er, Vermonters. Today, just two years later, OneCare — the cost saving program — is asking for $1.36 billion, and the right to expand their services to 250,000.

An excellent article in VTDigger outlines just how far off the mark the reality is from the original promises:

  • OneCare is losing money. The model is not profitable (and therefore not sustainable).
  • The number of Medicaid patients utilizing primary care services has dropped. Use of primary preventative care was supposed to increase. That was the whole point!
  • To quote: “The company has also not yet produced any evidence that the initiative has made people healthier. In fact, OneCare performed worse in 7 out of 10 Medicaid quality scores in 2018.
  • OneCare is not realizing savings either through efficiencies or healthier patients.
  • Bureaucratic/Administrative costs are increasing.

The article also quotes various people associated with the program both on the corporate side and the government side as saying one way or another, “It’s too early to tell” if the programs is going to be successful.

Well, flashback to 2017: “Todd Moore, chief executive officer of OneCare, said everyone involved should have a feel for how well the new approach is working by 2019. If all goes according to plan, he said the new system will cut the annual growth in health care expenditures in half, saving hundreds of millions of dollars over five years and reducing insurance premiums for Vermonters.” (Burlington Free Press, 12/21/17, emphasis added)

2019 is here! In fact it’s almost over. Did OneCare deliver on any of those goals outlined by its CEO? Yes, we now have a feel for how this massive government intrusion into the health care market is working. It isn’t. It’s time to pull the plug on this program now, before it gets to be “too big to fail.” There is no way it should be allowed to expand to cover more Vermonters until it has a proven track record of success within its original experimental population. If it can’t deliver there, and it hasn’t, scrap it.

Rob Roper is president of the Ethan Allen Institute. Reprinted with permission from the Ethan Allen Institute Blog.

Image courtesy of U.S. Navy
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