Nearly two years after abandoning its plans to establish the nation's first single-payer health care system, Vermont is forging ahead with another health care initiative that is less ambitious but could still make it a shining star for health reform advocates.

The Green Mountain State will become the first in the nation to set up a statewide all-payer accountable care organization that is open to all payers, including Medicaid, Medicare and commercial insurers.

The goal of the system is to develop uniform payments for medical services, no matter who is paying. ACOs that join the system will be paid the same amount for medical services by Medicare, Medicaid and commercial plans.