Health System Reform

transforming Vermont's health system

Vermont continues to lead the nation in transforming health systems to provide better care, lower cost, and improve the health of the population. 

Improving access to health care and the quality of medical care is essential. However, it is insufficient in improving health as health care is a relatively small contributor to health outcomes. Ultimately health system reform should create a better match between spending and the contributors to positive health outcomes. 

Public health approaches that address the multiple factors affecting health outcomes and focus on prevention and are essential to population health improvement. Public health offers prevention strategies, including investments in community-wide infrastructure and policy changes, to reduce disparities in the distribution of health and wellness.

State Health System Reforms

At the state level, public health is working to ensure that preventing illness and addressing the social determinants of health are integrated in the payment and care reforms through incentives, quality measures and development of a population health plan. State health system partners have adopted five key principles for population health improvement as part of the Population Health Plan to guide future efforts.

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Regional System Integration

The Health Department is working on reform efforts that build upon local resources and are responsive to the needs of each community or region’s unique population.

Our 12 local health offices are partnering with the Community Collaboratives, supported by the Blueprint for Health, ACOs, and the Vermont Health Care Innovation Project to explore the creation of Accountable Communities for Health. Accountable Communities for Health support integration of high-quality medical care, mental health services, substance use disorder treatment, and long-term services and supports, and incorporate social services for those in need of care. It also supports investments in community infrastructure and community-wide prevention efforts to reduce disparities in the distribution of health and wellness.

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Clinical Partnerships

The Health Department works with clinical providers to support efforts that integrate physical, mental health and substance abuse care and community services.Public health applies a population perspective to clinical care, and identifies opportunities to include prevention strategies in clinical and community settings that support life-long health and wellness. 

Examples of ongoing efforts:

  • The Planning & Health Care Quality Unit has developed Prevention Change Packets. These packets provide suggested evidence-based and best practices to include prevention in addressing health issues in three settings: traditional clinical care, patient centered care and community service connection, and in the broader community.
  • The Division of Health Promotion and Disease Prevention partners with the Blueprint for Health's network of community health teams to implement projects to reduce chronic disease. The Vermont Blueprint for Health aims to establish a medical home for all Vermonters and transform the way primary care and comprehensive health services are delivered and paid for.
  • The Division of Alcohol and Drug Abuse Programs is a critical partner in the Care Alliance for Opioid Addiction – a statewide partnership of clinicians and treatment centers to provide Medication Assisted Therapy (MAT) to Vermonters who are addicted to opioids. The Health Department and Blueprint are the governmental sponsors of the Hub & Spoke Medication Assisted Therapy program for individuals battling opioid addiction.
  • SBIRT (Screening, Brief Intervention and Referral to Treatment), sponsored by the Division of Alcohol and Drug Abuse Programs, is an evidence-based public health approach for identifying patients who use alcohol and other drugs at risky levels with the goal of reducing and preventing related health consequences, disease, accidents and injuries.
  • The Maternal and Child Health Division participates in the monthly Primary Care and Public Health Integration meeting convenes the leadership of MCH, VCHIP, AAPVT, VT AAFP, Planned Parenthood, ObGyn physicians, and primary care internal medicine providers, to coordinate various projects that cross borders. This group tackles key public health issues for children, adolescents, and young adults.
Health in All Policies

The Health Department is also working to engage non-health partners whose policies, programs and investments impact health due to their influence on the social determinants of health – the circumstances in which people are born, grow up, live, work and age, as well as the systems put in place to deal with illness. These circumstances are in turn shaped by a wider set of forces: economics, social policies and politics.

Find out more about Health in All Policies (HiAP)

Determinants of Health Equity