Healthcare Reform Takes Shape
The Senate Health and Welfare Committee is considering significant healthcare reforms aimed at increasing access and affordability. The legislation calls for a statewide healthcare delivery plan, directing the Green Mountain Care Board (GMCB) and the Agency of Human Services (AHS) to identify ways to expand access, reduce administrative burdens, and address service gaps. Business groups and insurers support this effort, provided it builds on existing planning structures and remains practical, cost-conscious, and transparent.
Strategies to create a centralized clinical and claims data system to improve efficiency and collaboration are also part of this plan. However, ensuring comprehensive Medicare data integration, quality, continuity, and cost-effectiveness before implementation remains vital.
The committee is also considering hospital budget oversight and payment reform, directing the GMCB to explore reference-based pricing (RBP), a model that ties commercial hospital rates to a percentage of Medicare prices. Stakeholders have expressed concerns over this transition, highlighting the need for both hospital and payer input, phased-in implementation, and safeguards against unintended consequences.
The inclusion of total cost of care targets and global hospital budgets has prompted calls for alignment with existing models and additional resources to maintain access and quality. Concerns remain about implementation without a federal agreement on Medicare payments and ensuring rural hospitals remain financially stable.
The bill also expands the GMCB’s regulatory authority and staffing, allocating new funding to the board rather than reallocating existing resources. Some stakeholders warn that the proposal could lead to rigid mandates, tying hospital service reductions directly to lower health insurance premiums.
While insurance rates are not the primary focus of this bill, lawmakers hope these system reforms will ultimately help control costs and increase efficiency in the healthcare system. The Vermont Chamber continues to advocate for solutions that promote affordability, sustainability, and limit regulatory burden for Vermont employers and employees.
