by Devon Green, VP of Government Relations, Vermont Association of Hospitals and Health Systems
Legislative Update
CORRECTION: Last week, we said that House Health Care heard testimony on H.545, the Immunization Recommendations Bill, when it was House Human Services. Thank you to the eagle-eyed reader who pointed this out to us. We welcome all corrections and clarifications.
Affordability: Week 2 at the legislature kept the focus on health care affordability. It began with the Senate Health and Welfare Committee hearing from Shawn Tester, CEO of Northeastern Vermont Regional Hospital and VAHHS Board Chair. He presented the VAHHS Affordability Action Plan and highlighted the work done at his hospital, including eliminating administrative positions, to achieve significant operational savings for FY 2026.
House Health Care wrapped up the week by delving into the hospital budget process with testimony from the regulator, the regulated, and the public advocate. To start, the Green Mountain Care Board, as the regulator, provided background on how hospital budgets work and noted future plans, including:
- FY 2027 guidance will have different benchmarks for different hospitals, as opposed to a single number across all hospitals
- The GMCB will implement reference-based pricing more widely through Act 68’s rate-setting authority in FY 2028
Editorial note: The hospital pledge to reduce operational costs by $100M over the next two years under the VAHHS Affordability Action Plan would provide a bridge to Vermont’s implementation of reference-based pricing.
Dr. Stephen Leffler, CEO of UVM Health and CEO of UVM Medical Center, acknowledged Vermont’s affordability crisis and testified that UVM Health has three goals:
- Quality—regain 5 start status with CMS
- Access—bring wait times for specialty and primary care below the national average
- Affordability—come as close to breakeven to Medicare on as many services as possible
He also reported that UVM Health, through legislation and Green Mountain Care Board regulation, took $160-170M in operational costs out of the UVM Health system for FY 2026 and has restructured the network board to include the chair of each hospital’s board. Dr. Leffler also addressed concerns about money going to UVM Health’s New York hospitals by emphasizing the right care at the right place at the right time. Supporting certain New York patients at their community hospitals frees up access for Vermonters at UVMMC while having acute patients that the New York hospitals are not equipped to handle sent to UVMMC helps provide the volume of patients needed to sustain specialized care, such as the neo-natal intensive care unit.
Finally, the Office of the Health Care Advocate testified on their role and requested that the legislature set specific goals to achieve affordability.
Consent for Recording Telehealth: A huge thank you to the House Health Care Committee for advancing H. 84, which allows the recording of telehealth visits with patient consent. The Committee heard from Justin Stinnett-Donnelly, MD, Chief Health Information Officer at UVM Health who presented on ambient documentation. He performed an “exam” on Rep. Leslie Goldman using ambient documentation and emphasized that ambient documentation has prevented retirements and increased morale for health care providers. The committee also heard from Vermont Care Partners and mental health care providers on the importance of recording telehealth sessions for training purposes. The committee raised issues around the use of the data and artificial intelligence but agreed to revisit them in the future. The committee voted 10-0-1 in support of the bill.
Immunization Recommendations: This was the week that the Vermont Department of Health presented on H. 545 in House Health Care, stating that the bill is needed to:
- Create a clear and transparent process for issuing immunization recommendations that considers the science
- Allow for flexibility to purchase recommended immunizations from any source
- Ensure private health insurers continue to cover recommended immunizations
- Address potential barriers faced by health care providers to prescribe and administer recommended immunizations
VAHHS supports H.545.
Transportation: VAHHS updated the House Transportation Committee on the work being done by the working group for the coordination of health care services and transportation services. The working group was formed to coordinate the scheduling of health care appointments and shared rides and found opportunities with coordinating hospital volunteers as ride volunteers, coordination of rides for dialysis appointments, and potential coordination with new transportation scheduling software.
Prescription Drug Discount Program: The Office of the State Treasurer testified on H.577, which would set up a discount drug program that would benefit the uninsured, underinsured, and seniors without pharmacy coverage. The State Treasurer’s Office testified that the cost of the program would be $50,000 in currently available funding for outreach purposes and a small per-transaction fee built into the drug discount.
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