The odor of scorched
tires, faint but unmistakable, figuratively hung over last week’s meeting
between the Green Mountain Care Board and representatives of Vermont’s hospitals. For the first time, the rubber began
hitting the road on health care cost containment in the state, the linchpin of
Governor Peter Shumlin’s single payer reform initiative.
The Green Mountain Care Board has now completed its approval process for
the coming year’s budgets for Vermont’s
14 hospitals. It was the board’s first effort and marked the third iteration in
the state’s effort to regulate health care costs. The first was the Hospital
Data Council that ran through the 1980s and early 1990s; that morphed into
BISHCA, which first got the power to set budgets in the mid-1990s; and now the
Green Mountain Care Board, which has the same powers as BISHCA, but should have
far greater weight than its predecessor.
Fletcher Allen Health Care of Burlington
and the Dartmouth-Hitchcock Medical Center of Lebanon, N.H., which have
competed for decades to treat Vermont’s
sickest patients, last week sought federal approval to jointly manage Medicare
patients in Vermont.
The state of Vermont is set to
receive several hundred million dollars in new Medicaid funds as part of the
Affordable Care Act. Vermont’s Medicaid program will benefit from the Affordable
Care Act because the state’s congressional delegation worked to increase Vermont’s overall Medicaid funding rate.