An evolving landscape for Medicare Advantage (MA) plans and economic pressures have led to the difficult decision to reduce the service area for UVM Health Advantage (UVMHA) for the upcoming plan year. The MA plan, co-created by MVP Health Care (MVP) and University of Vermont Health Network (UVMHN), will no longer be available in Vermont beginning January 1, 2025. However, the plan will continue to be available to residents in five designated northern New York counties. Vermonters currently enrolled in the plan will have an opportunity to transition to alternative options in the upcoming annual enrollment period beginning October 15th.
The current MA model is no longer sustainable in Vermont, given sharply increasing post-pandemic surges in care utilization and difficult regulatory changes on the horizon in 2025.
"In the face of necessary strategic change and given the knowledge that certain upcoming regulatory adjustments are inevitable, we find ourselves needing to narrow our focus," expressed Dr. Richard Dal Col, President of MVP Health Care. "Our partnership with UVMHN, characterized by a mutual commitment to innovation and improving the health of the communities we serve, remains robust and continues outside the context of the UVM Health Advantage plan."
The impact of providing increased amounts and more serious types of care is also exacerbated by Vermont-specific caps put on Medicare reimbursement set by the Centers for Medicare and Medicaid Services (CMS), which have led to financial challenges for the plan and care providers in the state.
“Across our region, we see the many challenges related to delivering sustainable health care, as costs continue to rise for both patients and the people who provide that care,” said Sunny Eappen, MD, MBA, President and CEO of UVM Health Network. “While UVM Health Advantage will no longer be offered in Vermont, we’re here to support our patients who are impacted by this change and we will continue to be here for them moving forward. We look forward to continuing our partnership with MVP in new ways and I’m incredibly thankful to our physicians who have influenced our joint MA plan.”
Who does this impact?
- This service area reduction only affects MVP’s MA customers in Vermont including MVP’s MA Employer Group Waiver Plans (EGWP).
- MVP’s commercially insured customers enrolled through the State of Vermont Health Connect or through employer sponsored insurance are not affected.
- All MVP customers will continue to have access to UVMHN providers.
- As a safety net provider, UVM Health Network will always provide emergency care to anyone who walks through the door, regardless of what insurance they have or whether they have insurance at all.
Next steps for those impacted in Vermont:
Vermont residents currently enrolled in a UVMHA plan will need to select an alternate health insurance coverage option during the forthcoming Annual Enrollment Period, which begins on October 15th and ends on December 7th.
To explore new health plan options, affected customers can:
- Call the Vermont State Health Insurance Assistance Program at 1-800-642-5119. Counselors are available to answer questions, discuss needs, and give information about options. All counseling is free.
- Call 1-800-MEDICARE (1-800-633-4227). This toll-free help line is available 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048.
- Visit Medicare.gov. Select Supplements & Other Insurance for information on Medigap policies and tools to find plans. Click the Find plans tab to compare plans.
Additional Resources
For more information, MVP customers can call 1-833-303-4687.
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