Project Narrative Vermont Health Care Reform Hcr Vermont

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payment reform necessary but not sufficient condition for doing what we want to do all right it's important but it doesn't work by itself and we learned that over and over and over again you know you've got to build will be calling system pneus we've done that in two steps phase one was implementing a set of enhanced medical home pilots I'm going to scribe this in some details or we wanted to focus on the primary care practice as the cornerstone of any delivery system change you don't have a strong and effective you know care coordination and capabilities at the primary care level nothing else is going to work folks and that that's our belief and we've been building working for that phase two was to say okay we've done the work on the primary care side how do we stand the reform to what Elliot Fisher call the neighborhood of the medical home the specialist that they work with the community hospital where they practice the other caregivers that are involved in the care of that populatio