MONTPELIER >> A pending deal between the state and federal governments will give a big boost to efforts by Vermont's largest health care provider to get 80 percent of its revenue by 2018 for keeping people healthy, rather than treating illnesses, the top official at the University of Vermont Medical Center said Friday.

UVM Medical Center CEO Dr. John Brumsted said his organization now receives between 25 and 30 percent of its revenue for keeping patients healthy, almost twice as much as last fall when the organization announced its goal. Once Vermont's deal with the federal government that would allow the Medicare and Medicaid patients in the state to be treated in the same way, the organization's revenue for keeping patients healthy could jump to about 50 to 60 percent of its total revenue.

"It's provided us the opportunity to improve health care delivery to Vermonters, changing the emphasis from fixing you up when you are ill or injured to doing that, but really providing the incentives to keeping you well," Brumsted said.

On Wednesday, Gov. Peter Shumlin announced the state had reached an agreement with the federal government so payments for Medicare patients in Vermont and those in the state administered Medicaid program, as well as private insurance, can focus on paying providers to keep patients healthy.

Officials in the industry believe the long-term solution to reducing health care costs is changing the way health care is paid for, to focus on keeping patients healthy rather than paying to treat them when they are sick. In theory, it both saves money and improves the lives of patients.


Providers are given a set amount of money to care for patients. If their care exceeds the amount, the provider has to pay it. If the care is less, the provider and all patients benefit.

A series of public hearings have been scheduled for early October to give the public the opportunity to weigh in on Vermont's so-called All Payer Model. It's hoped the plan can be fully implemented by January 2018, said Robin Lunge, the governor's director of health care reform.

Last year, UVM Medical Center announced its ambitious goal of getting 80 percent of its revenue for keeping patients healthy rather than being paid for services.

The change in the doctor's office means patients will be encouraged to get more involved in their care, while the health care providers and their staffs have changed the way they plan the care they provide.

Arnold Sherman, 77, of South Burlington, who is being treated for diabetes at his Colchester doctor's office, said the staff keeps him up on his appointments so he doesn't need to take an appointment card when he leaves.

"They are really good and their follow up is excellent," Sherman said.

Dr. Alicia Jacobs, of the UVM Medical Center's Colchester family practice and Sherman's physician, helped develop the system. One of the many changes is that every three months her staff creates a report on diabetes patients to see how the patients are doing so they can arrange follow-up as needed.

Changing the funding can take the process even further.

"Vermont is pretty amazingly innovative when it comes to health care delivery," Jacobs said.