Windsor — Early in Samantha Ball’s time at Windsor Community Health Clinic at Mt. Ascutney Hospital and Health Center, a female patient called her in tears.

The woman lacked health insurance and had found a lump in her breast, Ball told the Green Mountain Care Board during a meeting last week at the Windsor hospital. Through Vermont Health Connect, the state’s health insurance exchange, Ball was able to help the woman get insurance. The patient then quickly got the care she needed for what turned out to be stage 3 breast cancer.

“She is doing wonderful,” Ball, who now is coordinator of the community clinic, said in an audio recording of the meeting. “I get a Christmas card from her every year.”

Helping patients sort out how to pay for the care they need is one of the ways Mt. Ascutney and its partners are working to improve the health of people in the community. They say they’re doing this work in part because they believe it’s the right thing to do for patients, but also because Mt. Ascutney is preparing to increase its commitment to the accountable care organization OneCare Vermont and the risk-based contracts it oversees.

Through such contracts with payers such as Medicare, Medicaid and Blue Cross Blue Shield of Vermont, hospitals receive per-patient lump sums, rather than being paid for each visit or procedure. If a patient’s care ends up exceeding the annual amount, the hospital is on the hook for the difference.

In 2018, Mt. Ascutney has participated in such a contract with Medicaid. Next year, it also plans to make similar arrangements with Medicare and Blue Cross, Mt. Ascutney CEO Joseph Perras said at the meeting.

Such contracts provide an incentive for Mt. Ascutney to promote community preventive health strategies, many of which Mt. Ascutney already had been developing in recent years.

Guided by the results of the hospital’s community health needs assessment — which uses surveys to assess the community’s priorities — Mt. Ascutney’s community health team and Windsor-area partners are working to address a wide array of challenges, including access to mental health and addiction treatment, recreational opportunities, family and economic support; transportation; adult dental care, medications and healthy foods.

“Nobody’s surprised at this list,” Jill Lord, Mt. Ascutney’s director of community health, said at the meeting. “This is where we need to go to make a difference.”

Doing so means preventing illness in healthy people and preventing worsening health in people with chronic disease, Lord said.

“We want to optimize the health of the people that we serve,” Lord said.

To prevent illness, Melanie Sheehan, Mt. Ascutney’s…

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