MONTPELIER — Vermont's largest health care provider is embarking on an ambitious project of getting 80 percent of its revenue by 2018 for keeping its patients healthy rather than being paid for the amount of care it provides to patients.

To make the change in such a short time, patients of the University of Vermont Medical Center, its affiliated doctor's offices and other providers will be hearing more in the coming months about the best ways to keep themselves healthy, said UVM CEO Dr. John Brumsted.

"If we are accountable to keep you healthy we're going to reach out to you," Brumsted said. "Right now it's quite the opposite. I reach out to my primary care practice and usually it's when I'm at death's doorstep with the flu."

Getting paid for keeping patients healthy rather than the services provided to those patients is a broad goal of the nation's health care system, both as a way to improve patients' daily lives and reduce costs.

Earlier this year the U.S. Department of Health and Human Services set a goal for Medicare of getting half of its revenue through alternative payment models — such as Accountable Care Organizations or bundled payment arrangements — by the end of 2018. And a number of the nation's health care providers recently committed to getting 75 percent of their revenue based on the health of their patients by 2020.

The 80 percent goal set by UVM for all its income, from Medicare, Medicaid and private insurers, exceeds both of those goals.


"It is an ambitious goal," Brumsted said. "I believe — we believe — that it really is the appropriate approach to have care for populations be reimbursed in a way that provides freedom for the providers of health care and those consuming health care."

Lawrence Miller, Vermont's chief of health care reform, said the move to keeping patients healthier is a big part of the state's health care reform efforts. While UVM's 80 percent goal is ambitious, Miller said it's achievable.

"It's actually very cool stuff," Miller said of UVM's effort.

Don George, the president and CEO of Blue Cross Blue Shield of Vermont, said the state's largest health insurance provider is also working to change the health care payment model and supports UVM's goal.

"Blue Cross has for several years had it as a primary strategic agenda for our organization to pay providers for quality instead of quantity, exactly as John expressed it," George said Friday.

Brumsted said that now between 10 and 15 percent of UVM's revenue comes from some sort of prepaid arraignment. It is going to be a big change to move toward the 80 percent goal in three years.

He hopes that once the goal is reached it will minimize future increases in health care costs.

Brumsted said people across Vermont who get their care from the UVM Medical Center and its affiliates can expect to be hearing more from their provider.

"We will be reaching out to engage you to keep yourself as healthy as you possibly can and we will provide you user-friendly ways to do that," Brumsted said. "We will, I believe, in the near term be doing things that you see every day."