DVHA outlines Medicaid path toward hospital global budgets as OneCare winds down

Alicia Cooper, director of Managed Care Operations at the Department of Vermont Health Access, told the House Committee on Health Care that DVHA has implemented fixed prospective payments for hospitals through its Vermont Medicaid Next Generation ACO program and began a complementary Global Payment Program pilot in 2024. "We began our thinking about hospital global budget methodologies in tandem with the state's negotiations for the AHEAD model," Cooper said, noting the department is developing a Medicaid hospital global budget methodology to align with Medicare requirements for hospital global budgets.

Cooper said the department views hospital global budgets as an evolution of the fixed-payment approach that will preserve revenue predictability for hospitals, continue incentives for value and population health, and offer budget predictability for Medicaid. "Hospital global budgets represent an evolution of fixed payments for hospitals from where we have…