Vermont is a model health system under review for lowering costs

According to ABC news, OneCare Vermont covered about 24,000 Medicaid patients and now covers about 112,000 patients whose health care is provided through Medicare, Medicaid and commercial insurance.

The long-term goal is to expand it so that about 70 percent of health care services provided in Vermont are covered by the system, which encourages patients to stay healthier using specialized care, such as helping them manage chronic conditions like diabetes so they don't wind up needing more expensive treatment. 

It's essentially an incentive for doctors and the companies that employ them. There are limits to both the risk and the possible benefit, but when the care costs less than the amount allocated, providers can keep the difference. Conversely, when it costs more, they have to make up for it.

In addition to traditional health care, such programs also focus on "social determinants of health," such as housing, transportation and nutrition, which frequently have more to do with health than available medical care.