Improve Chronic Care Management

Improve Quality of Care across the Lifespan

More than half of all Vermont adults have one or more chronic conditions (e.g., diabetes, hypertension, cardiovascular disease, asthma, arthritis, cancer, respiratory diseases, depression and other mental health disorders, substance dependence and many others).

Chronic conditions are the leading cause of illness, disability, and death in Vermont and caring for Vermonters with chronic conditions consumes more than three-quarters of the funds spent in the state each year on health care. As such, Vermont has decided to redesign our state’s health system to improve care for those with chronic conditions.

Launched in 2003 by Governor Jim Douglas, as a public–private partnership, the Blueprint for Health was fully endorsed in Act 191 as Vermont’s plan for a statewide system of care that improves the lives of individuals with, and at risk for, chronic conditions. The Vermont Department of Health submitted the Blueprint for Health: Strategic Plan to the legislature in January 2007 and an updated Annual Plan in January 2008.

In addition to statewide implementation of the Blueprint by 2011, Act 71 of the 2007 session calls for 3 Integrated Medical Home Pilot Projects to be implemented in 2008. The health care reform also includes multiple other strategies to improve the care for chronic conditions, all of which must be aligned with the Blueprint standards:

• A new Chronic Care Management Program (CCMP) for Vermonters enrolled in Medicaid, Dr. Dynasaur and VHAP. The Medicaid program payment structure also must be realigned to support health care professionals to provide care for people with chronic conditions.
• The state’s self-insured health care plan for employees is required to have chronic care management as a component of the contract re-bid process in 2006.
• Carriers offering Catamount Health plans are required to have a chronic care management program available to their Catamount Health beneficiaries, and must waive cost-sharing for beneficiaries that are actively participating in those programs.
• Employer-Sponsored Insurance (ESI) plans approved by the state for the premium assistance programs must include chronic care coverage consistent with Blueprint. In addition, the state’s premium assistance program will cover all chronic care cost-sharing amounts for beneficiaries enrolled in a chronic care management program.
• Informational packets on chronic fatigue syndrome will be available to providers and the public to broaden understanding and awareness of this debilitating condition.