The prognosis for OneCare, Vermont’s latest effort to bring down the cost and improve the quality of health care, is being called into question lately by both doctors and patients.

OneCare’s mission is to end traditional fee-for-service health care, which is thought to incentivize doctors and hospitals to perform more tests and procedures, and move to a “capitated” system in which providers are paid a fixed amount to take care of a group of patients. 

The organization is in the third year of a five-year pilot that includes ambitious targets for enrolling Vermonters in the program. It’s not hitting those targets, which prompted a response from the Centers for Medicare and Medicaid Services (CMS). CMS partnered with the state to work with OneCare. 

OneCare Vermont office in Colchester (Photo: Kevin Hurley)

On Sept. 14, CMS sent a notice to the Green Mountain Care Board, which oversees all aspects of