Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 0 | 0 | 0 | 0 | 22,613 | 22,613 |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | 0 | 0 | ||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | 0 | ||||
| 4 | Total. Add lines 1 through 3 | 0 | 0 | 0 | 0 | 22,613 | 22,613 |
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | 0 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 22,613 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 0 | 0 | 0 | 0 | 22,613 | 22,613 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 163,676 | 163,676 | ||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | 0 | |||||
| 11 | Total support. Add lines 7 through 10 | 186,289 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2020 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2020 |
(iii) Distributable Amount for 2020 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2020 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2020: | ||||
| a From 2015....... | ||||
| b From 2016....... | ||||
| c From 2017....... | ||||
| d From 2018....... | ||||
| e From 2019....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2020 distributable amount | ||||
|
i
Carryover from 2015 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2020 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2020 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2020, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2020. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2021. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2016..... | ||||
| b Excess from 2017..... | ||||
| c Excess from 2018..... | ||||
| d Excess from 2019..... | ||||
| e Excess from 2020..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART II, LINE 12 | THE ORGANIZATION'S CURRENT TAX YEAR REFLECTS OCTOBER 26, 2020 THROUGH DECEMBER 31, 2020 ACTIVITY (A SHORT PERIOD). THIS IS DUE TO 2020 BEING THE ORGANIZATION'S INITIAL 990 RETURN. |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART III, LINE 1 | INNOVATIVE PAYMENTS MADE (MISSION CON'T) DURING THIS SHORT TAX PERIOD, PAYMENTS MADE TO PROVIDERS FOSTERING INNOVATION AND BETTER OUTCOMES INCLUDE FIXED PROSPECTIVE PAYMENTS OF $66M AND MEDICARE BLUEPRINT FUNDING OF $1.4M WHICH ARE NETTED OUT ENTIRELY ON THIS RETURN FOR PURPOSES OF FOLLOWING US GAAP. INNOVATIVE PAYMENTS TO THE NETWORK REPORTED ON THIS RETURN INCLUDE POPULATION HEALTH MANAGEMENT PAYMENTS OF $1.6M, COMPLEX CARE COORDINATION PROGRAM OF $1.1M, VALUE BASED INCENTIVE FUND OF $456K, AND PRIMARY PREVENTION PROGRAMS AND GRANTS OF $391K (SEE SCHEDULE I FOR DETAILS). FORM 990, PART III, LINE 4A NETWORK PERFORMANCE MANAGEMENT FURTHERED THE DEVELOPMENT OF FRAMEWORK FOR SUCCESSFUL CLINICAL PROGRAMS. ONECARE CLINICAL LEADERSHIP RAPIDLY PIVOTED FOCUS TO SUPPORT PROVIDERS WITH SCALE UP AND DEPLOYMENT OF TELE HEALTH SERVICES WHEN THE COVID-19 PANDEMIC SHUT DOWN IN PERSON CARE. PROVIDED CONTENT EXPERTISE AND WORKED WITH PAYERS AND ASSOCIATES TO CLARIFY RULES, DISSEMINATE INFORMATION AND TRAIN PROVIDERS. CONDUCTED FOCUSED AUDITS OF THE QUALITY OF PARTICIPATION ACROSS THE ENTIRE SPECTRUM OF CARE IN NEWLY DEVELOPED VALUE BASED CARE PROGRAM. AUDITS OCCURRED IN Q3 & Q4 AND INFORMED PROGRAM DESIGN CHANGES CONCURRENTLY AS WELL AS FOR FUTURE PROGRAM YEARS. CONCURRENTLY AS WELL AS FOR FUTURE PROGRAM YEARS. |
| FORM 990, PART III, LINE 4B | DATA AND ANALYTICS FURTHERED USAGE OF CROSS PAYER/PROVIDER DATA SETS UNIQUE TO ACO TO CONSIDER NEEDS OF NETWORK STRIVING TO SHIFT TO A POPULATION HEALTH MODEL. ANALYZED AND CREATED VISUALIZATION AIDS WHICH PROVIDED RISK BEARING ENTITIES ACTIONABLE FINANCIAL REPORTS WITH WHICH THEY COULD IDENTIFY THEIR INDIVIDUAL FINANCIAL PERFORMANCE UNDER THE ALL PAYER MODEL. DEVELOPED DASHBOARDS IN SUPPORT OF MONITORING PERFORMANCE OBLIGATIONS. UTILIZED INFORMATION PROVIDED ALONGSIDE PARTICIPANT LED GOVERNANCE BODIES TO DISCUSS WAYS TO PROVIDE INCENTIVES WHICH WOULD BE MOST LIKELY TO IMPROVE PERFORMANCE. HELD STRATEGIC PLANNING RETREATS TO PROVIDE INSIGHTS AND INFORM FUTURE REPORTING. |
| FORM 990, PART III, LINE 4C | PAYMENT REFORM PROVIDED STRUCTURE NECESSARY TO ALLOW FOR FURTHERANCE OF THE ACO MODEL OF CARE WHICH INCLUDES BOTH CLINICAL AND FINANCIAL ACCOUNTABILITIES. SUCCESSFUL IN MODIFICATION OF PARTICIPANT CONTRACTS TO ENSURE ALIGNMENT OF FINANCIAL AND CLINICAL ACCOUNTABILITIES. MODIFIED 2020 AND 2021 RISK CORRIDORS GIVEN UNCERTAINTY DUE TO THE IMPACT OF COVID-19 ON PROVIDERS. WORKED TO INFORM PAYER DECISIONS TO MITIGATE OR IN SOME CASES ELIMINATE THE FINANCIAL RISK PROVIDERS WOULD SUFFER DUE TO COVID-19. SECURED CARES ACT FUNDS TO OFFSET IMPACT OF MEDICARE RECONCILIATION SO THAT THE BENEFIT OF REFORM EFFORTS WOULD NOT BE ERODED BY PANDEMIC. IMPLEMENTATION OF A NEWLY DEVELOPED VALUE BASED CARE PAYMENT MODEL THAT ALLOWED PAYMENT TO MOVE FROM CAPACITY BUILDING PHASE TO REWARDING ACTUAL CARE MANAGEMENT PERFORMED. WORKED WITH SEVEN HOME HEALTH PROVIDERS TO PILOT A LONGITUDINAL CARE PROGRAM DESIGNED TO DELIVER IN HOME SERVICES AT RISK OF RE-HOSPITALIZATION. PROGRAM WAS DESIGNED TO INCLUDED PATIENT POPULATIONS, REGARDLESS OF WHETHER OR NOT THE PATIENT WAS ATTRIBUTED TO ONE CARE. DATA WAS COLLECTED AND EVALUATED COMPARING EMERGENCY DEPARTMENT AND INPATIENT UTILIZATION PRE AND POST PROGRAM ENROLLMENT. FOR THOSE PATIENTS ATTRIBUTED TO ONE CARE, INPATIENT UTILIZATION REDUCED BY 64%, ED UTILIZATION BY 36%. FOR THOSE NOT ATTRIBUTED TO ONE CARE, INPATIENT UTILIZATION WAS REDUCED BY 42% AND ED UTILIZATION DECREASED BY 64%. THE RESULTS SHOWED POSITIVE PROGRESS AND WILL BE CONTINUED INTO 2021. |
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERS ONECARE VERMONT IS A LIMITED LIABILITY CORPORATION, FOUNDED IN 2012. ONECARE HAS TWO MEMBERS, THE UNIVERSITY OF VERMONT HEALTH NETWORK, AND DARTMOUTH HITCHCOCK HEALTH. |
| FORM 990, PART VI, SECTION A, LINE 7A | MEMBER APPOINTMENTS TO GOVERNING BODY EACH MEMBER OF ONE CARE HAS THE RIGHT TO APPOINT THREE MEMBERS OF THE GOVERNING BODY. THE GOVERNING BODY IS COMPRISED OF UP TO TWENTY-ONE MEMBERS IN TOTAL. OTHER MEMBERS OF THE GOVERNING BODY REPRESENT SPECIFIC PROVIDER TYPES REPRESENTED IN ONECARE'S PROVIDER NETWORK, AS SET OUT IN THE ORGANIZATION'S OPERATING AGREEMENT. |
| FORM 990, PART VI, SECTION B, LINE 11B | RETURN PREPARATOIN ONECARE VERMONT'S FORM 990 IS PREPARED BY ONECARE STAFF AND REVIEWED BY PRICEWATERHOUSECOOPERS (PWC). FOLLOWING PWC'S REVIEW, THE RETURN IS REVIEWED BY ONECARE'S SENIOR LEADERSHIP. FINALLY, ONECARE'S MANAGEMENT PRESENTS THE FORM 990 TO THE FINANCE COMMITTEE FOR REVIEW AND COMMENT. THE COMPLETED FORM 990 IS PROVIDED TO ALL MEMBERS OF THE ONECARE BOARD OF MANAGERS PRIOR TO BEING FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | MONITORING OF THE CONFLICT OF INTEREST POLICY THE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. IN ACCORDANCE WITH THE POLICY, BOARD OF TRUSTEES, OFFICERS AND CERTAIN OTHER INDIVIDUALS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE AND CERTIFICATION UPON HIRING, AT LEAST ANNUALLY, PRIOR TO PARTICIPATING IN ANY DECISION THAT MAY BE AFFECTED BY A PERSONAL INTEREST, AND WHENEVER A POTENTIALLY CONFLICTING INTEREST FIRST ARISES. THE CONFLICT OF INTEREST POLICY IS ENFORCED BY THE ONECARE COMPLIANCE TEAM, WHO REPORTS AT LEAST ANNUALLY ON CONFLICT OF INTEREST ISSUES TO THE AUDIT COMMITTEE OF THE BOARD OF MANAGERS. CONFLICTS OF INTEREST ARE MANAGED IN ACCORDANCE WITH THE POLICY, WHICH PROVIDES FOR A VARIETY OF REMEDIES TO ADDRESS CONFLICTS OF INTEREST. REMEDIES TO ADDRESS CONFLICTS OF INTEREST MAY INCLUDE THE FOLLOWING: RECUSAL FROM DECISION MAKING, DISCLOSURE TO APPROPRIATE PARTIES, COMMITTEE PARTICIPATION LIMITS AND REQUESTED DIVESTITURE. AN APPEALS PROCESS EXISTS SHOULD THE INDIVIDUAL REQUEST A SECONDARY REVIEW BE PERFORMED. |
| FORM 990, PART VI, SECTION B, LINES 15A AND 15B | COMPENSATION DETERMINATION POLICY ONECARE UTILIZES THE SERVICES OF THE UNIVERSITY OF VERMONT HEALTH NETWORK (THE 'HEALTH NETWORK') IN THE SETTING OF ALL COMPENSATION. COMPENSATION DETERMINATION IS SUBJECT TO THE HEALTH NETWORK'S COMPENSATION FRAMEWORK, WHICH INVOLVES UTILIZATION OF NATIONAL AND REGIONAL PEER GROUPS, TARGETING THE 50TH PERCENTILE, WITH PERFORMANCE BASED VARIABLE PAY OPPORTUNITIES. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENT DISCLOSURE GOVERNANCE DOCUMENTS CONSIST OF THE ORGANIZATION'S ARTICLES OF INCORPORATION AND OPERATING AGREEMENT. THE ARTICLES OF INCORPORATION ARE FILED WITH THE VERMONT SECRETARY FO STATE AND ARE PUBLICLY AVAILABLE THROUGH THAT OFFICE. THE OPERATING AGREEMENT IS NOT PUBLICLY POSTED, BUT A COPY WOULD BE FURNISHED TO ANY MEMBER OF THE PUBLIC WHO REQUESTED ONE. |
| FORM 990, PART VI, LINE 2 | BUSINESS RELATIONSHIPS DR. JOHN BRUMSTED AND TODD KEATING SERVED AS DIRECTORS AND OFFICERS AT THE UNIVERSITY OF VERMONT HEALTH NETWORK, AN UNRELATED ORGANIZATION, WHERE DR. STEVE LEFFLER SERVED AS A KEY EMPLOYEE. DR. JOHN BRUMSTED AND DR. STEVE LEFFLER SERVED AS DIRECTORS AND OFFICERS AT THE UNIVERSITY OF VERMONT MEDICAL CENTER, AN UNRELATED ORGANIZATION, WHERE TODD KEATING SERVED AS A KEY EMPLOYEE. ALL ONECARE STAFF ARE EMPLOYED BY UVMC, AN UNRELATED ORGANIZATION. ONECARE VERMONT REIMBURSES UVMC FOR THE FULL ECONOMIC COST OF THE EMPLOYEES' EFFORTS. TWO EXCEPTIONS TO THIS ARE DR. NORMAN WARD AND DR. SUSAN SHANE WHO ARE ALSO EMPLOYED PART TIME AS PHYSICIANS WITHIN THE UNIVERSITY OF VERMONT HEALTH NETWORK MEDICAL GROUP. |
| FORM 990, PART X - COLUMN A | ONECARE WAS ESTABLISHED IN 2012 AS AN LLC AND ELECTED TAX TREATMENT AS A PARTNERSHIP. THE IRS RECOGNIZED OCV AS A TAX-EXEMPT ORGANIZATION AS OF OCTOBER 26, 2020. FOR THIS REASON, THERE ARE BEGINNING YEAR BALANCES IN THE BALANCE SHEET DESPITE BEING AN INITIAL YEAR RETURN. |
| FORM 990, PART XI, LINE 3 | THE FINANCIAL INFORMATION REFLECTS REVENUE AND EXPENSE FOR THE PERIOD COVERED BY THE RETURN. LOSS REPORTED ON THIS LINE IS NOT REPRESENTATIVE OF THE ENTIRE YEAR DUE TO YEAR-END ADJUSTMENTS. |
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