In This Issue
Kathleen A. Bizarro, FACHE
Peter J. Wright, FACHE
Gerald J. Vicenzi, FACHE
Immediate Past President
Board of Directors
Kris Doody, RN, FACHE
Bea Grause, FACHE
Tina Legere, FACHE
Henry D. Lipman, FACHE
Patsy Aprile, FACHE
Joseph L. Woodin
William J. Lipkin-Moore, FACHE
Karen Clements, FACHE
Message from the VT Regent - April 2010|
Vermont Legislative Update – April 2010
The Vermont legislature continues to grapple with a number of issues that will likely have a direct impact on hospitals and their patients. With less than one month to go, lawmakers are under immense pressure to find ways to cut the state budget without harming vulnerable Vermonters or dismantling investments in current or planned healthcare reform solutions.
Hospital Cost Containment
The Vermont Association of Hospitals and Health Systems (VAHHS) and hospital representatives have been working with legislative leaders and state regulators to balance hospital “belt-tightening” measures without jeopardizing a hospitals' ability to respond to community needs. VAHHS remains cautiously optimistic that this balance can be achieved, but warns that the alternative outcome could mean undue restrictions on every hospital's need for flexibility and autonomy.
The State Budget
Lawmakers are hearing about the negative impact cuts will have on Vermonters and it is becoming clear to them that cutting costs does not reduce the need for services. Many of the cuts, including those to the mental health system, are part of a controversial proposal called “Challenges for Change.” The proposal is a joint effort by the administration and legislative leaders to reduce government spending by $38 million for SFY2011 through efficiencies, consolidation and cuts. While some of the proposed cuts have been rescinded, the state budget bill has already passed the house and there is little time to identify alternative savings of $38 million.
VAHHS is working to help the State close the existing budget gap in an effort to preserve access to healthcare services. Our primary approach is by devising new solutions around a provider tax that the state collects from hospitals (except the Vermont State Hospital and the VA). Even this solution will not solve the growing gap between patient’s healthcare needs and the State's ability to meet those needs through the Medicaid program.
State Healthcare Reform
Vermont already has more than 60 healthcare reform initiatives “in the pan”, but even with these reforms in place, the system is unsustainable. Some legislators think that, like an omelet, the system must be “flipped” at some point. S.88, a bill that proposes to study at least three health system redesigns recently passed the Senate. The bill is headed to the House Healthcare Committee where the Chair plans to merge it with legislation he has been working on. While it is likely that some form of healthcare reform will pass, it may not amount to more than a study or new instructions on how to continue reform efforts.
Impact of Federal Healthcare Reform on Vermont
While there is financial risk for all hospitals in the new federal law, there are also several opportunities for pilots, grants and expansions that would provide federal assistance for programs that Vermont plans to or has already implemented. For example, thanks to the legislation, Medicare may begin participating in the Blueprint for Health, Vermont’s integrated chronic care initiative. This would provide enhanced payments to primary care physicians and help fund community health teams.
Hospitals are concerned about provisions that would cut payments as coverage increases. Vermont has a very low rate of uninsured and there is no guarantee hospitals will see the increased coverage translate into utilization of services.