Policy Update
Federal Health Care Issues
Although impeachment hearings dominate the national news coverage, there’s been a holiday flurry of activity with federal bills and rules coming out of Washington D.C.

Passing or extending a spending bill that delays disproportionate share hospital (DSH) cuts and funds health care programs:  The current short-term 2020 spending bill expires on December 20. If the spending bill is not extended, funding reauthorization for community health centers, national health service corps, Medicare quality programs and special diabetes programs will lose funding. Additionally, DSH cuts will go into effect on January 1, 2020. These cuts will not affect Vermont hospitals in the first year or two due to the fact that the State of Vermont cut a total of $15 million in DSH funding from the FY 2019 and FY 2018 budgets. Congress may pass complete appropriation bills or a short-term spending bill. Either way, they will be looking for a way to fund programs and the delay in DSH cuts.

Surprise billing:  The Ways and Means Committee announced on Thursday that they have a  bi-partisan agreement  on legislation that would protect patients from surprise billing while allowing for a “robust, impartial and structured process” to determine the reimbursement from the insurer to the provider. Uninsured patients will also be able to participate in the process if they were provided misleading cost information by a provider. The proposed bi-partisan agreement also includes an exemption for existing state laws. 

Prescription drug bill:  The House of Representatives voted to approve the  Lower Prescription Costs Now Act , which would allow the federal government to negotiate prices for up to 250 drugs and limit the price of prescription drugs if prices grow faster than inflation. Rep. Peter Welch has been a driving force behind this bill. The Senate will likely not take the bill up. 

Transparency:  Currently, all hospitals post what they charge for health care services to a federal website. A federal  rule  set to go into effect on January 1, 2021 would require hospitals to post negotiated charges for all items and services provided by the hospital. Hospitals will also be required to post 300 common services in a consumer-friendly manner so individuals can easily comparison shop between hospitals. 

In the News
How a Vermont hospital is working to battle superbugs

Antibiotic-resistant bugs or superbugs are an ongoing public health threat across the globe. Health care facilities across Vermont say they're addressing the issue. Our Adam Sullivan shows you what's being done at the Gifford Medical Center in Randolph.

"Most of our patients here are going to get an antibiotic," said Jane McConnell, the pharmacy manager.

Antibiotics are mixed often at the Gifford Medical Center but not nearly as much as in the past.

"As soon as we determine something is not an infection, getting people off antibiotics, making sure we get the right antibiotics chosen each time and dosed correctly," McConnell said.

Becca Balint: Our rural life full of beauty and challenges
Brattleboro Reformer

The storm was going to be a big one; forecasters predicted 18-24 inches over several days. I needed to get the last of the wood stacked and move several days' worth of wood onto the back porch. I was eager to begin; I need these rituals. Despite the hard work — or perhaps because of it — they're meditative and connect me with the rhythm of the season and the tempo and cadence of a rural life.

Vermont's rural character is a tremendous gift to all of us. My children have an understanding of agriculture and a deep appreciation of the beauty of the forests and the working landscape. And they love to swim in the Rock River and look for crayfish and salamanders and pollywogs. When we're all stretched out on boulders in the sun — "lizarding" I call it — and listening to the rush of the river and the laughter of other swimmers, everything feels exactly right. But like all my legislative colleagues in Windham County, I worry about our rural communities and the lives of our constituents.

We are a rural county, and our challenges mirror those of rural communities across the nation. According to a Pew Research Center report from May 2018, "What Unites and Divides Urban, Suburban and Rural Communities," rural counties — particularly in the Midwest and Northeast of the U.S. — are losing people. We have higher death rates than birth rates, and more people are moving away than moving in. Pew Research studied 1,969 rural counties; almost 1,200 of these counties have fewer people employed today than they did 20 years ago.

Feds free up Medicaid funding for psychiatric patients
Vermont Business Magazine

Vermont can use Medicaid money to pay for psychiatric care, providing stability to the state’s mental health system.

On Tuesday, the federal Centers for Medicare and Medicaid Services granted a “waiver,” allowing the state to use federal money to pay for short-term mental health care in the state’s larger institutions. The existing funding source was set to run out.

The waiver makes certain that the state will have a steady stream of money to fund beds in psychiatric hospitals. Lawmakers say the money will ensure that Vermonters can get the mental health care they need, keep patients out of emergency rooms, and provide a reliable source of funding for hospitals. Vermont received the second such waiver from the feds; the first went to Washington D.C., earlier this year.

Officials finalize 10-year vision for mental health policy

Vermont’s Department of Mental Health is preparing to unveil a plan for the next decade that aims to more closely integrate mental and physical health care

The plan, expected to be submitted to the Legislature next month, lays out a vision to guide policymaking over the next 10 years. While officials and advocates are setting out broad goals in the blueprint, the plan is not closely focused on specifics.

Health care professionals and officials met Wednesday at the Waterbury state office complex for a “think tank” discussion as they finalized the report, which envisions eliminating stigma around mental health and expanding community-based treatment programs.

"Provider consolidation may well be driving costs around the country in many circumstances. While we have much work to do in Vermont to make healthcare more affordable, this is one trend that does not apply here," Dr. Leffler and Ms. Stickney wrote. "The Network is helping us preserve access in our rural communities, not raise prices."

Brumsted: Benefits of OneCare begin to emerge
Vermont Business Magazine

There can be no debate: Accessing health care services can be difficult at times, navigating our complex system can be confusing, and we all know that health care costs too much for far too many families.  

This is why the University of Vermont Health Network is "all-in" on the State's policy demanding real changes in the way we deliver health care and the way we operate the health care system. To achieve these incredibly difficult goals, we became a founding member of OneCare Vermont. 

OneCare Vermont is a cooperative effort of providers who have pooled their resources and expertise to keep people healthy and well with a focus on increasing access to primary care, reducing deaths from suicide and drug overdose, and supporting Vermonters with chronic illnesses. OneCare is the health care provider community’s contribution to bringing about the change the federal government and the State of Vermont have envisioned in the All-Payer Model, and, I am excited to share, we are starting to see a big difference. 

OneCare brings providers and health care organizations together with their resources, people, systems and dollars, and collectively make the investments necessary to improve the health of the population we serve. 

Health care and beverage industries team up to reduce sugar intake
Vermont Business Magazine

In a unique partnership between RiseVT, the lead primary prevention strategy for OneCare Vermont, and the Beverage Association of Vermont, the state association of non-alcoholic beverage distributors, local patrons in stores and restaurants are being encouraged to select low-and-no sugar beverage options from coolers with “Sweet Enough” signage.

Sweet Enough is a new behavior change marketing campaign launched by RiseVT this fall to encourage Vermonters to enjoy the sweet things in life, while being mindful of their beverage choices as a part of a balanced lifestyle. Americans consume 3 – 6 times more added sugar than the maximum recommended amount by the American Heart Association and Centers for Disease Prevention (CDC)1.

The beverage industry is on board with promoting their low-and-no sugar options, as the industry believes it has a role to play in educating consumers and raising awareness about different beverage options that meet people’s unique lifestyle choices. Their participation in the Sweet Enough campaign complements their commitment to reduce beverage calories consumed nationally per person by an additional 20% by 2025. America’s leading beverage manufacturers, including The Coca-Cola Company, PepsiCo and Keurig Dr Pepper have been working together to achieve this goal through their Balance Calories Initiative. The latest independent analysis of this initiative shows progress toward the national goal of reducing the calories and sugar that Americans get from beverages.

New MRI Suite opens at Northeastern Vermont Regional Hospital
Vermont Business Magazine

After eight years of operating out of a mobile MRI unit, Northeastern Vermont Regional Hospital (NVRH) held an official open house and ribbon cutting for its new MRI Suite on Friday, December 6, 2019.

The new MRI addition is a significant upgrade for the hospital’s Diagnostic Imaging wing. The increased space and new layout improves workflow as well as efficiency for staff. The new space and equipment will also allow for future growth of MRI services.

The open house featured tours of the MRI addition’s space and attendees viewed the MRI room. Several individuals spoke to the significance of this new addition. NVRH CEO Shawn Tester welcomed attendees and introduced why the new MRI suite is important to NVRH and the rest of the community.

“By building this addition, we are going beyond just meeting our patients’ needs,” Tester said. “This new space allows us to engage in a more dynamic and patient-focused experience.”

People in the News