Legislative Update 4-15-19
SIM Final Impact Analysis: Secretary Gobeille and Director Backus presented the recent findings from the Centers for Medicare and Medicaid Services (CMS) on the State Innovation Model (SIM) Final Impact Analysis which show the Vermont ACO SSP yielded $97 million in Medicaid savings over 3 years relative to spending for an in-state comparison group. Vermont had a statistically significant slower increase in total Medicaid expenditures. Vermont showed comparatively lower rates of emergency department visits and inpatient admissions. The report also noted the strong stakeholder and provider involvement, stating: “Although still in its early implementation phase, Vermont’s All-Payer ACO Model, which was developed under and informed by the SIM Initiative, is expected to continue the momentum of payment and delivery model reform across the state.” (p. F-63).
Prohibiting Prior Authorizations for MAT: The House Health Care Committee heard testimony on S.43, which prohibits commercial insurers from requiring prior authorization requirements for medication-assisted treatment (MAT). The committee asked why the bill was limited to commercial plans and noted that prohibiting prior authorizations for MAT could be a starting point for a larger conversation around prior authorizations.
Health Care Workforce: Bi-State Primary Care testified on health care workforce needs in Senate Health and Welfare. Bi-State highlighted the need for housing and employment for partners as well and explained the importance of focusing recruitment outside the state in order to grow the workforce. Among Bi-State’s recommendations was loan repayment programs as and improving the quality of work life for health care providers.
Study on Primary Care Funding: The House Health Care Committee passed S.53, an act relating to determining the proportion of health care spending allocated to primary care. This study will help establish a baseline of current health care spending on primary care and help inform policy makers whether more spending on primary care is needed.
Substance Misuse Prevention: The Senate Health and Welfare Committee and House Human Services held a joint hearing on substance misuse prevention. The committee took testimony from representatives for Vermont’s congressional delegation, the Department of Health, and the Agency of Education on available federal grant opportunities, current state efforts, and the importance of addressing the social determinants of health in reducing substance misuse.
Integration of Social Services Report: House Health Care, after doing a deep-dive with OneCare Vermont and the Blueprint for Health on health care reform efforts and coordination of care will take a look at S.7, an act requesting reporting on social service integration with Vermont’s health care system.
Rural Health Services Task Force: Last week, the Senate Health and Welfare Committee amended H.528, an act relating to the Rural Health Services Task Force, to add a representative from the Office of Rural Health and Primary Care from the Department of Health and a representative from Vermont’s free clinic programs. The committee also has the task force consulting with the Accountable Care Organization and addressing how to improve coordination of care between hospitals and community providers. The committee will be discussing the bill this week and holding a possible vote.