Legislative Update
Devon Green, VP of Government Relations
Legislators want to know what hospitals are doing to address Vermont’s affordability and access issues. I’m here to tell you that hospitals, even during great uncertainty at the federal and state level, are doing everything they can to reduce costs and increase access for Vermonters. We have innovative partnerships between hospitals and EMS to provide more care in the home, partnerships between hospitals and housing organizations to give Vermonters medical care in a home rather than an emergency department. Vermont’s hospitals are rethinking the entire system of care with mid-size hospitals taking on sicker patients and smaller hospitals taking back patients from the largest hospitals to free up access at a more affordable cost. Hospitals are also taking a hard look at services and personnel and making cuts for further affordability. For some more information on what hospitals are doing, you can go here. Vermont’s hospitals are also looking forward to engaging in the next step of Act 167 and receive technical assistance from the Rural Health Redesign Center to translate transformation from theoretical recommendations to the reality of caring for patients.
Here's what else happened last week:
Budget: Governor Scott gave his budget address. Below are the health care initiatives:
Authorizes AHS to work with CMS on a State Directed Payment model for Medicaid.
$4.4M to transition towards a global payment model
Funding to support the Blueprint for Health and Support and Services at Home (SASH) programs after the end of the All Payer Model
Certificate of Need (CON) Proposals: The Senate Health and Welfare Committee walked through S.10 and S.20. Chair Lyons and Sen. Gulick, sponsors of each bill, noted that these bills stem from the Green Mountain Care Board’s Act 167 recommendations from Oliver Wyman. Legislative counsel said the purpose of the CON process is to review and assess any new health care project to avoid duplication, reduce costs, and ensure high quality and access. The two bills are very similar with the differences being:
Exclusion of replacing medical equipment that fully depreciated
Building or expansion of an ambulatory surgical center for $10M—right now any ambulatory surgical center must obtain a CON
S.10 has a difference between hospital thresholds and independent provider thresholds and S.20 has almost all thresholds set at $10M
Single piece of diagnostic equipment in S.10 is $5M and $10M in S.20
Offering a health care services is $3M in S.10 and $10M in S.20
S.10 sets the conceptual development threshold at $100M and S.20 sets it at $50M
Chair Lyons, who sponsored S.10 noted that she was not wedded to any single number, Rep. Gulick appeared more committed to S.20. The next step for the committee is to take testimony.
Claims Edits and Prior Authorization: The House Health Care Committee advanced H.31, which ensures that the claims edits requirements from Act 111 do not apply to out of state claims and clarifies the definition of a primary care provider.
Birthing Centers: The Senate Health and Welfare Committee heard about S.18, which establishes licensure of freestanding birthing centers in Vermont. The House Health Care Committee heard about H.40, which is the House version of the bill.
Green Mountain Care Board: The House Health Care Committee heard an introduction from the Green Mountain Care board and received an update on the Act 167 report.
Health Care Reform: The Agency of Human Services gave an update on Vermont’s health care reform efforts, including the AHEAD model.