More than half of Vermont adults have one or more chronic conditions (e.g., diabetes, hypertension, cardiovascular disease, asthma, arthritis, cancer, respiratory diseases, depression and other mental health disorders, substance dependence and many others).  Chronic conditions are the leading cause of illness, disability, and death in Vermont and caring for Vermonters with chronic conditions consumes more than three-quarters of the funds spent in the state each year on health care. As such, Vermont has decided to redesign our state’s health system to improve care for those with chronic conditions and prevent them from occuring.

Launched in 2003 by Governor Jim Douglas, as a public–private partnership, the Blueprint for Health was fully endorsed in Act 191 as Vermont’s plan for a statewide system of care that improves the lives of individuals with, and at risk for, chronic conditions.  In addition to statewide implementation of the Blueprint by 2011, Act 71 of the 2007 and Act 204 of 2008 session calls for 3 Integrated Medical Home Pilot Projects to be implemented in 2008.

The health care reform also includes multiple other strategies to improve the care for chronic conditions, all of which must be aligned with the Blueprint standards:

• A new Chronic Care Management Program (CCMP) for Vermonters enrolled in Medicaid, Dr. Dynasaur and VHAP. The Medicaid program payment structure also must be realigned to support health care professionals to provide care for people with chronic conditions.
• The self-insured health care plan for state employees was required to have chronic care management as a component of the contract re-bid process in 2006.
• Carriers offering Catamount Health plans are required to have chronic care management programs and must waive cost-sharing for beneficiaries that are actively participating in those programs.