Vermont's Community-Oriented All-Payer Medical Home Model Reduces Expenditures and Utilization While Delivering High-Quality Care.

Patient-centered medical home programs using different design and implementation strategies are being tested across the United States, and the impact of these programs on outcomes for a general population remains unclear. Vermont has pursued a statewide all-payer program wherein medical home practices are supported with additional staffing from a locally organized shared resource, the community health team. Using a 6-year, sequential, cross-sectional methodology, this study reviewed annual cost, utilization, and quality outcomes for patients attributed to 123 practices participating in the program as of December 2013 versus a comparison population from each year attributed to nonparticipating practices.

Effect of benefits counseling services on employment outcomes for people with psychiatric disabilities.

Objective: This study examined the impact of specialized benefits counseling services on levels of competitive employment for people with psychiatric disabilities receiving Social Security Administration (SSA) disability benefits in Vermont.

Methods: Beneficiaries who had a psychiatric disability and who received specialized benefits counseling (N = 364) were compared with matched contemporaneous and historical control participants over four years, two years before and two years after the initiation of the intervention. Study participants were consumers of vocational rehabilitation services, and the outcome measure was quarterly earnings from state unemployment insurance program records.