Chairwoman Lyons briefly explained some of the basic reasons for the bill, including realigning elements of the health care system with both public and private insurers, while moving toward an All-Payer Model. It would focus on equitable reimbursements and ensure sustainability for all primary physicians, since we are losing so many, particularly in rural areas.
NOTE: We are unsure how All-Payer is going to assist in this regard as the current model for this reform is run by large hospital networks.
The bill proposes to transfer certain duties from the Green Mountain Care Board (GMCB) to the Director of Health Care Reform in the Agency of Human Services and to modify, or eliminate, other Board duties. It would specify that the Board’s review, consideration, and approval of hospital budgets and of certification and budgets of accountable care organizations (ACOs) are the deliberations of a public body in connection with a quasi-judicial proceeding. The bill would direct the Board to adopt rules to establish processes for certifying Medicare-only ACOs and would direct the Board of Nursing to adopt rules establishing a student nurse apprenticeship program.
The bill would require insurers to participate in multi-payer alternative payment models and would require non-binding mediation conducted by the GMCB prior to the termination of a contract between a health care provider and a health plan. The bill would require alignment of certain health insurer credentialing practices, quality measures, and data collection. It would revise aspects of the GMCB’s hospital budget review processes and require the Secretary of State to provide training for the Board’s members and staff.
The bill also would require reports on:
- Population-based hospital budgeting.
- Realignment of the timing of the GMCB’s regulatory process.
- Review and approval of mergers, affiliations, and divestments involving Vermont-based health care providers.
- Designating a single State agency for coordination of clinical health care data.