Vermont Proposes Risk-Bearing, State-Run Medicaid Managed Care Entity

The Vermont Agency of Human Services (AHS) Department of Vermont Health Access (DVHA) is planning to launch a risk-bearing, state-run Medicaid managed care entity. The new entity would receive a monthly capitated population-based payment to cover physical and mental health, pharmacy services, addiction treatment services, and long-term services and supports (LTSS) beginning January 1, 2022.

AHS presented its plans in a proposed Medicaid waiver application, “Vermont Global Commitment to Health Section 1115 Demonstration,” submitted to the U.S. Department of Health and Human Services (HHS) on June 29, 2021. The state’s 1115 demonstration was first . . .