Vermont Department of Health Access

This Quality Strategy outlines Vermont's comprehensive and dynamic continuous quality improvement plan for its Medicaid Program, aiming to advance population-wide coverage, implement innovative care models, engage Vermonters in health transformation, strengthen care coordination and population health management, and accelerate payment reform. Key initiatives include expanding benefits and eligibility, refining the managed care delivery system, advancing population health through strategic investments, and supporting systemic delivery reform. The strategy targets the achievement of universal access to healthcare, cost containment, and improved quality of care by setting measurable goals and objectives to be met by December 31, 2027.

This two-year Medicaid provider revalidation strategy outlines Vermont's approach to maintaining program integrity, accuracy, and completeness of provider enrollment data. The plan prioritizes six strategic goals: ensuring data accuracy, meeting federal revalidation requirements, enhancing program integrity, improving provider directory reliability, streamlining the provider experience, and ensuring access to care. Key activities include off-cycle revalidations for high-risk and moderate-risk providers, comprehensive reviews of provider type risk level designations, evaluation of revalidation schedules, and consideration of enrollment moratoria. The strategy aims to proactively identify and address fraud, waste, and abuse while minimizing disruption to essential healthcare services for Vermonters.

The town hall meeting provided an overview of the role and purpose of the Beneficiary Advisory Committee, which serves to advise the state Medicaid program on policy development and effective administration. The discussion covered the background of the committee, requirements for participation, and the application process for appointed positions. Additionally, the importance of lived experience from current or past Medicaid beneficiaries, family members, and caregivers was emphasized to help guide the Medicaid program. The session also addressed the commitment to accessible meeting formats and the provision of necessary support for committee members.

The Vermont Medicaid Quality Strategy is a comprehensive plan for continuous quality improvement within the state's Medicaid program. It outlines a blueprint for assessing beneficiary care quality and establishing measurable goals, driven by core priorities including advancing population-wide coverage, implementing innovative care models, engaging Vermonters in health transformation, strengthening care coordination, and accelerating payment reform. Key initiatives address Substance Use Disorder, Serious Mental Illness, and Long Term Services and Supports, with objectives focused on enhancing the experience of care, improving health outcomes, promoting chronic disease treatment, fostering wellness and preventive care, ensuring access to services, and increasing community integration and independence.

The meeting agenda included a roll call and the approval of prior meeting minutes from January 26, 2026. Key discussion items centered on an update from the Beneficiary Advisory Committee (BAC), followed by committee business including a wrap-up of the Marketplace and Open Enrollment period. Specific attention was given to the proposed budget, Home and Community Based Services (HCBS) Quality Activities, updates from the Medicaid Director and the Commissioner's Office, and a period for public comment.