Governor Shumlin highlights health care reform progress, Anya Rader Wallack to step down as chair

by Andrew Stein March 27, 2013 vtdigger.org Anya Rader Wallack, chair of the Green Mountain Care Board and perhaps the single most important person in Vermont's health care reform effort, announced on Wednesday that she is resigning less than two years into her seven-year term. She will leave at the end of September.
Wallack was a key architect of Act 48, the benchmark health care bill that established the Green Mountain Care Board and set the state on course to create a single-payer system. As chair of the board, Wallack’ s primary task has been to control the growth of health care costs in Vermont.
Wallack is leaving the board in September to resume living with her family in Rhode Island.
‘ To do a job like this, and to be a good spouse and to be a good parent, is an incredible challenge,’ she said. ‘ And to do that with your family five hours away, and seeing them every two or three weeks, is more than a challenge ‘ it’ s just impossible.’
Wallack’ s fellow board member Al Gobeille is set to replace the veteran health care policymaker. Gobeille, who has a brief background in health care policy, is a longtime restaurateur and is praised by his peers for his leadership abilities and skills with finances. He is Gov. Peter Shumlin’ s top choice to replace Wallack.
‘ It’ s great to have a business person, who has the respect of the business community leading the charge,’ Shumlin said.
Con Hogan, who is a board member and former secretary of the Agency of Human Services, praised Gobeille.
‘ He is a natural leader. He is the kind of guy who, I think, can keep us moving in the right direction,’ he said. ‘ Some of the feedback from the press at this point is that he doesn’ t have a policy background. Well the board does, and it’ s a strong board.’
Wallack touted Gobeille’ s strengths on a balance sheet.
‘ When we went through hospital budgets, he was my man,’ she said. ‘ He really understands finances.’
At a press conference on Wednesday, Shumlin told reporters that Gobeille would only accept the chair position if he had someone with Wallack’ s policy background to assist the board. The governor said his ‘ preference would be that Anya be that person.’
Wallack said she currently plans to return to running her firm Arrowhead Health Analytics, LLC, which has consulted to the state of Vermont. While she would not commit to working with the board in the future, she hinted at it.
‘ It is really hard to walk away from this,’ she said. ‘ It feels like I’ m putting up my baby for adoption. So, the idea that I’ d walk away is a bit hard to fathom.’
Shumlin said he would lobby Wallack for the next six months to stay on board, even if from afar.
‘ I just want to tell you, from the bottom of my heart, that we would not be where we are as the first state to implement the first sensible health care system in America if it were not for Anya’ s extraordinary contributions, knowledge, skill and ability to get things done,’ Shumlin said.
Vermonters for Health Care Freedom, a vocal opponent of Vermont's first-in-the-nation health care exchange, pounced on the news of Wallack's resignation.
A statement issued by Darcie Johnston said: "Vermonters for Health Care Freedom has called upon Governor Shumlin and the Legislature to immediately repeal the Health Benefits Exchange mandate and allow Vermont businesses and individuals to also purchase insurance from the traditional marketplace, as is being done in every other state.
"VHCF was stunned by the news that Green Mountain Care Board Chair Anya Ryder Wallack has, at this critical time, decided to resign. This action puts into greater jeopardy Vermont’ s ability to successfully launch the Health Benefits Exchange System, called Vermont Health Connect, by October 1st.
"This action further threatens Vermont’ s high quality health care system and amplifies the uncertainty for businesses and individuals who are trying to plan and make decisions for health care insurance coverage next year under the Exchange. According to the administration officials 118,000 Vermonters are now at risk.
"Within the next few days the rate filings for the Exchange plans will be made public. Vermonters will be shocked by the dramatically higher premiums imposed by these reforms. VHCF predicts that reform-induced price hikes will force thousands of Vermonters to drop their health coverage. If the Shumlin Administration and the Legislature would simply allow the insurance market to operate along with the Exchange, all of this could be avoided.
"Vermonters for Health Care Freedom is in the process of launching a Doctor ‘ Patient Network to protect doctors’ rights to practice medicine and patients’ rights to contract with providers for their services - without government intervention in the doctor/patient relationship. We believe this is critical to preserving and protecting Vermont’ s high quality health care system now that uncertainty about our health care future is at unprecedented levels."
Mark Larson, Commissioner of the Department of Vermont Health Access, which will run the state exchange, said that because of the hard work going on behind the scenes, the complex Exchange systems are operational and on schedule.
"Through Vermont Health Connect, Vermonters will be able to make side-by-side comparisons of their health coverage options ‘ including both private and public plans,’ Larson said. ‘ Vermont Health Connect will be the one place for Vermonters to 1) compare health coverage options, 2) enroll in the plan that’ s right for them, and 3) secure financial assistance.’
Governor Shumlin also identified several accomplishments in areas that are critical to the success of overall health reform:
Better Access to Care: 423,015 Vermonters are now being served through high-quality ‘ Blueprint for Health’ primary care practices, supported by Community Health Teams to prevent and manage chronic disease and improve their health.
Better Use of Technology: 83 percent of Vermont primary care physicians have electronic health records (EHRs), among the highest rates in the country. Most of these providers have connections to health information networks that now allow them to see test results electronically. All Vermont hospitals are now using EHRs.
Better Delivery Models: Vermont has the nation’ s only statewide Accountable Care Organization, OneCare, a network of 13 hospitals and 2,100 physicians organized to deliver better health care, more efficiently, to 60,000 Vermont Medicare beneficiaries.
Innovative Payment Models: Vermont recently received a federal grant of approximately $45 million to continue its progress developing models that tie payments to health outcomes. Moving from fee for service to outcomes-based payments over the next five years will help encourage improved quality, greater efficiency and better care coordination across physicians, hospitals, clinics, mental health practitioners and long-term services and supports.
Controlling Costs: Governor Shumlin reiterated that controlling costs is critical to creating a new healthcare system in Vermont. The Green Mountain Care Board has begun addressing currently unsustainable healthcare cost growth, setting a modest growth rate of 3 percent for hospital budgets for next year. The Board also recently denied rate increases for health insurance bought by individuals without employer-sponsored coverage.
Shumlin's budget proposal increased the reimbursement rate for Medicaid services by 3 percent in order to begin to address the "cost shift" that drives up private insurance premiums for individuals and businesses; the House budget under consideration adopts this recommendation.
The governor thanked the House for the healthcare provisions in the budget going to the floor this week, which include funds to make coverage purchased through Vermont Health Connect more affordable for 40,000 low and middle income Vermonters, and increase Medicaid provider rates.
Finally, Shumlin also announced that Green Mountain Care Board Chair Anya Rader Wallack will be stepping down from her current position at the end of September. The governor and legislative leadership fully support current board member Al Gobeille as the next chair of the board, and will ask the nine-member nominating committee to convene as soon as possible to finalize the new chair and set a schedule and process for selection of a new Board member.
‘ Anya has been a critical player from day one of my administration in leading Vermont’ s first-in-the-nation reform effort, and I am grateful that she has given so much of her time and expertise to the state,’ Shumlin said. ‘ Al Gobeille has become a true and trusted leader at the Board, and I believe he would provide a smooth transition to the Board if named as chair.’
Photos: State of Vermont. Al Gobeille and Anya Rader Wallack.
Timothy McQuiston of Vermont Business Magazine contributed to this report.