Report says Vermont’s Blueprint for Health has been successful

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(Host) A new report says Vermont’s program to lower medical costs for patients with chronic illnesses has been so successful that it should be expanded.

The report also found that Vermont has the most cost effective end of life care programs in the country.

VPR’s Bob Kinzel reports.

(Kinzel) When Vermont launched its Blueprint for Health program several years ago, the primary goal was to provide better health care for patients with chronic illnesses and reduce overall medical costs.

The program was started because 75 percent of all health care dollars in Vermont are linked to chronic illnesses.

Dr. Cyrus Jordan is the medical director of the Vermont Program for Quality in Health Care.

He says a new approach was needed because the acute care model – that is treating people for specific problems like broken arms and legs – didn’t work for patients with chronic illnesses.

(Jordan) "So it’s trying to make a system that’s more appropriate to be proactive and preventive and reach out."

(Kinzel) The program operates in several pilot communities and Jordan says it’s been a success. In most areas of the state, he says, patients with chronic illnesses get only about 50 percent of their recommended care. But in the Blueprint communities, where prevention and ongoing disease management programs are emphasized, the rate of appropriate care is much higher.

(Jordan) "When they all start, they’re like everybody else, about 50 percent. By giving them tools, giving them resources to try to treat their practices like they treat their patients, they’re able to get up to 80, 90, 100 percent. We have some data to show that it actually clinically helps. Like the lab data, it’s a little bit too early to show that the decrease in the hospitalizations but we know that hopefully that will come."

(Kinzel) Jordan also says the new report shows that Vermont has done an excellent job utilizing home health care and nursing home care for patients near the end of their lives.

(Jordan) "So that they are not hospitalized very frequently. When hospitalized, there’s not a lot of use of intensive care and the use of X-rays and tests, interestingly enough, is the lowest in the whole country. So it seems to be that, in the end of life care we’re developing a pretty good system."

(Kinzel) Helen Riehle is the executive director of the organization. She says the report raises concerns about the implementation of computerized health records because the budget to train health care providers about this technology has been cut.

(Riehle) "To me it’s kind of like you give someone a cell phone with 80 gazillion applications and you don’t show them how to use it or connect it to their practice but you’ve given it to them. They should be able to use because they’re smart – they’re doctors, right -and it’s going to change things."

(Kinzel) Riehle says the report also shows that the early identification and treatment of Vermonters with mental illness and substance abuse problems, is a cost effective way to provide these patients with better care at a lower expense.

For VPR News, I’m Bob Kinzel in Montpelier

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