Green Mountain Care Board Works To Decrease Cost Of Health Care

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(Host) Vermont’s doctors have formed a new organization to allow them to take an active role in forming a new state health care system in the coming years.

The new organization is needed to comply with federal anti-trust laws.

VPRs Bob Kinzel reports.

(Kinzel) One of the primary goals of the newly appointed Green Mountain Care Board is to develop policies that will slow down the rising cost of health care in Vermont.

This is important because Governor Peter Shumlin says he won’t pursue a single payer system in 2014 if the state hasn’t been able to control costs.

Anya Rader Wallack is the chair of the five person Green Mountain Care Board.

She says implementing a payment reform system for health care providers is a critical piece of the Board’s cost containment strategy.

(Rader-Wallack) "In my mind, first and foremost is payment reform so there’s a lot of payment reform activity going on and I think we need to quickly get a handle on what makes sense how to organize that and move it ahead at lightning speed."

It’s likely that any payment reform plan will try to replace the current "fee for service" system. That’s a system where providers get paid for every office visit, test or procedure. Rader-Wallack says changing this system could lead to significant savings.

This is why doctors want a voice in Vermont’s health care debate.

Paul Harrington is the vice president of the Vermont Medical Society. He says the creation of a group known as The Physicians Policy Council will allow doctors to be directly involved in key policy discussions involving payment reform:

(Harrington) "As a provider bargaining group it can negotiate with the new Green Mountain Care Board on issues related to payments to physicians, administrative burdens, health information technology things that they could not otherwise discuss effectively with the Green Mountain Care Board and not trip over federal anti trust laws."

(Kinzel) Harrington says the new group will also seek ways to have government health care programs pay a fair reimbursement rate to providers so that these costs aren’t shifted over to people who have private health insurance policies:

(Harrington) "Certainly it’s well known that the Vermont Medicaid program significantly underpays for services and commercial payers have to pay more in order to allow physicians to practice here in Vermont."

(Kinzel) Harrington says it’s critical for state officials to fully understand the impact that payment reform initiatives will have on health care providers before those policies are put into place.

For VPR News I’m Bob Kinzel in Montpelier.

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