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The home for VPR's coverage of health and health industry issues affecting the state of Vermont.

Shumlin Health Care Architect To Coordinate Regional Reform Efforts

Toby Talbot AP
Anya Rader Wallack testifies before the House Appropriations committee on Feb. 7, 2013 in Montpelier.

Anya RaderWallack, the principal architect of Gov. Peter Shumlin’s single-payer health care reform initiative, announced Monday that she has agreed to advise Dartmouth Hitchcock Medical Center on health reform issues across Maine, New Hampshire and Vermont.

Wallack said she will to continue to serve as coordinator of the $45 million federal State Innovation Model (SIM) grant that is supporting the development of reform infrastructure in Vermont’s health care delivery system. She said she would recuse herself from any Vermont-based actions that would directly benefit Dartmouth-Hitchcock.

Dartmouth-Hitchcock is a major player in the Vermont reform effort through its joint effort with Fletcher Allen Health Care of Burlington and Vermont’s 13 community hospitals to build quality and cost efficiency into the care of Vermont’s Medicare population.

 Governor Shumlin issued a statement that he welcomed the move. “I’m pleased Anya will be working with Dartmouth-Hitchcock to pursue many of the cost savings and quality improvements that are already underway here,” he said. “I think it is a positive development for our region.”

“We will continue to work with Anya through her role as chairman of our SIM grant and will of course expect the grant committee and participants to handle any conflicts that may arise,” he said.

The main work that lies ahead in the reform effort centers on the establishment of Accountable Care Organizations (ACOs) whose form was created in the federal Affordable Care Act.

Dartmouth-Hitchcock has been involved in earlier efforts to set up an ACO in New Hampshire, as well as the Vermont initiative with Fletcher Allen. A major portion of Dartmouth-Hitchcock’s patient load is made up of Vermont residents, especially those in the eastern part of the state.

Dartmouth-Hitchcock also has close ties to both the Maine Medical Center in Portland and Eastern Maine Medical Center in Bangor.

Dr. James Weinstein, the CEO of Dartmouth-Hitchcock, said that the New Hampshire organization hopes to build a delivery system based on population health and new payment models that would be sustainable into the future.

“I have the greatest respect for Anya’s knowledge, experience and innovative thinking about health care and health policy, and to that end we have been talking about how we might work together on projects…under which we would implement a totally ‘capitated’ model across Maine, New Hampshire and Vermont,” Weinstein said.

When Shumlin launched his single-payer initiative in early 2011, he named Wallack the chairperson of the Green Mountain Care Board, which was given the dual task of regulating hospital costs directly and building new structures like ACOs to enhance both quality and cost efficiency.

Last year, she stepped down from that position in order to return to her home in Rhode Island, but she has continued to work with the Vermont reform team as a consultant.

Wallack said she was “excited to help organize Dartmouth-Hitchcock’s creative thinking into something that could be a model of health care service delivery, health improvement and cost containment for the region and the country.”

Hamilton E. Davis is a longtime journalist, who has written for the Providence Journal and the Burlington Free Press.
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