Blueprint for Health official outlines statewide patient-centered medical home network and community health teams

John Saroyan, executive director of the Blueprint for Health, told the Health Care Committee that the statewide program centers on patient-centered medical homes, multidisciplinary community health teams and value-based per-member payments that pay for team-based supports without point-of-service billing to patients.

Saroyan said the Blueprint was codified in state statute, piloted in 2008, and expanded statewide through subsequent legislative action. He described the program—s four primary initiatives: recognized patient-centered medical homes, community health teams that provide social supports and care coordination, the hub-and-spoke medications-for-opioid-use-disorder system, and a pregnancy-intention initiative that expands access to family-planning services.

Saroyan summarized how the program is funded: large commercial insurers, Medicaid and Medicare pay prospective per-member-per-month amounts into the Blueprint. He told the committee that the standard patient-centered medical home payment is roughly $3 per member per month and community health team funding is approximately $2.77 per member per month; those perspective payments are designed to support teams and are not billed directly to patients. "There's no claim generated. I don't get a bill," he said of community health-team visits.

He described the program—s reach and activity: more than 70 percent of Vermonters are seen in Blueprint-supported practices, community health teams have served roughly 26,000 unique individuals with an estimated 75,000 points of contact over about two years, and the program divides the state into health-service areas with administrative entities that oversee local teams.

Saroyan acknowledged funding pressures and market changes he called out in the legislature—s Act 51 review, including shifting insurer participation (for example, Medicare Advantage and self-funded plans can affect payers' contributions). He said the legislature has asked the Blueprint to study alternative funding options and that the program is monitoring trends in payer participation.

He also highlighted performance and value: community health teams perform social-screening work, connect patients to housing and refrigeration for medications, and reduce emergency department use in many practices. Saroyan noted the program's quality requirements; participating practices must meet National Committee for Quality Assurance recognition standards for patient-centered medical homes.

Committee members asked about trends in payer participation and the challenge posed by Medicare Advantage and self-funded plans that may not contribute to the Blueprint pool. Saroyan said the legislature—s Act 51 report addressed funding options and that staff can return with more detailed trending on payer participation and potential policy responses.

Saroyan closed by citing patient and staff quotes from the Blueprint—s annual report to underscore the program—s local impact and urged continued legislative support to maintain and adapt the model as payer markets change.