Published: 1/12/2020 10:01:33 PM

Modified: 1/12/2020 10:00:49 PM

MONTPELIER — The company in charge of Vermont’s health care reform efforts will file for nonprofit status after state officials made it a requirement of receiving more taxpayer money.

Agency of Human Services Secretary Mike Smith told lawmakers Wednesday that he would provide OneCare Vermont with $5.7 million with strings attached: that the for-profit company seeks nonprofit status and becomes more accountable to the public.

“We’re connecting those investments to transparency,” Smith told the House Human Services Committee. “I believe that there needs to be more transparency in OneCare.”

OneCare, an accountable care organization, has been charged with implementing the state’s all-payer health care system as an effort to save money and keep Vermonters healthier. OneCare was formed by the University of Vermont Medical Center and Lebanon-based Dartmouth-Hitchcock Health.

The change in status would require that OneCare publicize financial and salary information and detail its revenue and expenses, and OneCare would become subject to some public records requests, Smith said. If OneCare cannot become a nonprofit, Smith said he would require them to adhere to the same accountability requirements if they want to receive state funding.

Smith made the move after his uncle told him at a family gathering that he didn’t like OneCare because it was for-profit. House Human Services Committee Chair Ann Pugh, D-South Burlington, echoed that sentiment and said she approved of Smith’s decision.

“We shouldn’t be making money off of health care,” she said. “I’m not saying OneCare was, but it’s a for-profit business so people wonder.”

In exchange for agreeing to those conditions, OneCare will receive a total of $5.7 million in cash to invest in primary care, mental health and health care coordination work. The Legislature must approve that money, which is included in an adjustment of the state budget partway through the fiscal year.

OneCare has agreed to the changes and is “actively exploring” 501(c)(3) status, according to CEO Vicki Loner. “To our knowledge, if the application were granted, OneCare would be the first ACO in the country to gain 501(c)(3) status, but we believe that status most accurately reflects the purpose and operations of the organization and its nonprofit members,” she said in a statement.

OneCare representatives have previously said that it’s not possible for the organization to move to nonprofit status: under state law, no more than half of a company’s board members can have a financial interest in the work of the nonprofit.

The majority of the OneCare board are hospital leaders, whose organizations stand to benefit from the success of health care reform. Smith said they could ask the IRS for an exemption.

The company has come under fire for its lack of transparency. It has not shared detailed salaries of its top earners or financial information. Last year, it fought a bill that would have given the state auditor increased access to its finances. In December, the Green Mountain Care Board also asked it to become more transparent as a condition of the budget approval.

OneCare spokesperson Amy Bodette said the accountable care organization already operates “in the spirit of a nonprofit.” But she added that OneCare stands to benefit from the change. “We want to be seen as a transparent organization,” she said.

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