State-level best practices in integrating prevention: The Vermont model to better health, better care, and lower costs through innovative public-private partnerships

With skyrocketing costs connected to obesity and chronic diseases, policies that may help prevent these are being embraced by state governors and legislatures. In addition, the Patient Protection and Affordable Care Act (ACA) has made federal funding and technical assistance available for state innovations in Medicare and Medicaid. This presentation describes the approach taken by Vermont to incorporate prevention-oriented strategies in Medicaid and other health programs. Beginning in 2003, Vermont launched Blueprint for Health to reduce health care costs associated with chronic disease by “promoting health maintenance, prevention, and care coordination and management.” The program has implemented a range of strategies including: multidisciplinary, local health and wellness teams; local grants to promote health behavior and prevent disease; self management education and support; payment and reimbursement reforms; and health IT upgrades. Several innovative financing and delivery strategies were used including Medicaid waivers and public-private partnerships. Vermont articulated specific performance objectives, several of which focused on patients with chronic conditions and preventive care, so that it could evaluate the success of its efforts. Relative to control group, participants have seen promising declines in rate of increase of overall expenditures, inpatient expenditures, and Emergency Department visits. This holds important lessons for other states who are struggling to improve population health through prevention and contain costs. It offers several models for innovative financing and delivery of programs. Describe a prevention-oriented program to reduce Medicaid costs, while achieving better health outcomes for patients Analyze coordinated care to focus on prevention wellness, nutrition, and physical activity