Legislature Report
For the Week Ending February 12, 2010
The Senate Health and Welfare Committee last week unveiled key components it will include in a draft bill designed to restrain the growth trends in health care costs. The committee intends to assemble a discussion draft bill that includes a model for accountable care organizations (ACO) for integrated delivery systems, a global budget for at least a portion of health care spending, and a requirement for a single statewide prescription drug formulary.
Senator Doug Racine, chair of the Health and Welfare Committee and a candidate for the Democratic nomination for governor, is a key participant in an ad hoc group of legislative health policy leaders that has been meeting weekly with hospitals, insurers, and other providers since the session began to discuss methods to control health care spending. Those discussions have focused on cost restraint through controls on hospital spending through global budgeting. Hospitals responded to those discussions last week by forcefully describing the impact of budget caps on their operations and listing some of the difficult choices they would face if such restraints were implemented.
The Senate Finance Committee last week heard additional testimony on S.262, a bill requiring private health benefit plans to include coverage for autism. Federal and state laws and regulations have assigned responsibility for services for autistic children to public Medicaid and school-based educational programs, but autism advocates have been sweeping the country promoting private coverage for more intensive services, up to 40-hours per week of one-on-one treatments for the most severe cases. Despite insurer testimony about the impact on premiums if responsibility for those services were shifted to private insurance, the committee agreed to continue work on the bill but consider some limitations to lessen the broad scope of the mandate.
Also last week, legislative consultant Dr. Ken Thorpe, chair of the health policy department at Emory University in Atlanta, met with the Senate Health and Welfare Committee and the House Health Care Committee in a joint session of the two committees on Tuesday afternoon. Thorpe told the committees he is optimistic about efforts to get federal approval for Medicare participation in the state’s Blueprint initiatives. Thorpe also said the state should continue to build its health care infrastructure under the Blueprint. He said that should include three key components:
- Continued expansion of health information technology through VITL
- Expansion of community health teams statewide
- Continued movement toward broader integration of services
Thorpe also recommended moving forward with changing how services are paid, including:
- Moving toward global budgeting
- Considering PMPM targets for ACOs that are being considered by the legislature
- Working to leverage as much participation as possible from Medicaid and Medicare.
- BCBSVT President and CEO Don George told the House Health Care Committee Thursday that BCBSVT is committed to the Blueprint expansion statewide as an appropriate step in improving care and controlling costs.
This week, the House Health Care Committee will hear the results of a study of the administrative cost effectiveness of the Catamount Health program for the uninsured, a state program privately administered by BCBSVT and MVP. The legislation creating Catamount in 2006 contained a provision for a study of private administration of the program. The committee will also take up a bill proposing the elimination of a number of boards and commissions for cost savings. Among those commissions listed for elimination are the Public Oversight Commission that advises BISHCA on certificate of need and hospital budgeting and the Vermont Program for Quality in Health Care (VPQHC) that performs quality reviews and initiatives.
If you are interested in this week’s Legislative Committee Meeting schedules, agendas, and a listing of other meetings and activities, please visit the Vermont Legislature’s website at http://www.leg.state.vt.us/schedule/schedule2.cfm
Committee meetings are normally updated daily, and are subject to change without notice. If you plan on attending, you may want to call ahead to verify the agenda.
For more information on legislative proposals, visit the Blue Cross and Blue Shield of