Vermont’s Plan to Transform Its Entire Health System

By Deepak Madala

Vermont is in the midst of an ambitious plan to simplify and streamline its entire health care system, including replacing its legacy eligibility and enrollment systems with a new system that meets the requirements of the Affordable Care Act. According to a recent Health Reform Enrollment Update from The Children’s Partnership, the state is integrating a number of historically separate information technology systems across various state and federal agencies to develop a new platform that coordinates enrollment, clinical, and insurance claims data for its consumers.

The state’s plan includes:

  • Developing a state-based health insurance exchange (HIX)—Governor Shumlin submitted a letter to HHS this month declaring Vermont’s official intent to establish a state-based exchange
  • Expanding the state’s existing health information exchange (HIE)
  • Continuing to support the state’s All Payer Claims Database (APCD)
  • Replacing the state’s Medicaid Management Information System (MMIS)

As part of the Early Innovator Grants that CCIIO awarded last year, Vermont is coordinating with six neighboring states in the New England area to share best practices and to pool resources. Like many states throughout the country, Vermont is also taking full advantage of federal funding available through the CMS enhanced “90/10 match” for improvements to existing Medicaid eligibility systems and the Health Exchange Establishment Grants to make these improvements to its information technology systems. On July 3rd, the state submitted an application for a $104.4 million establishment grant in order to have sufficient federal support for state implementation efforts through December 31, 2014. Vermont already has the smallest number of uninsured people of any state in the country and one of the lowest uninsured rates. But by taking full advantage of all the opportunities to get federal funding, the state is setting itself up to close the remaining gap and ensure all state residents enroll in health coverage.

The federal government recently announced an additional grant opportunity for states like Vermont that are seeking to coordinate systems across various state agencies. States should apply for this program very soon, as applications are due August 17, 2012.


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