Message from the CEO
Last week, we were pleased to host some 200 people at our 2019 Annual Meeting, entitled "Healthy Vermont Together: People, Passion, Promise." The event kicked off with a Moth-inspired story-telling event, apropos because the meeting was full of rich stories about the people who make health care in our state and in our country work.

We heard from Sister Carol Keehan, our Thursday keynote, who told stories of working with President Barack Obama on the Affordable Care Act. And we heard heart-wrenching stories from our Friday keynote, Benjamin Anderson, who used his experience as the father of two of the tiniest patients at his rural Kansas hospital to move his staff to more patient-centered care. Throughout the meeting, our breakouts were rich with stories from and about people in many sectors of the health care system. I am proud to say that we learned valuable lessons from all of them.

One of the hardest things about Annual Meeting for me and for many people is choosing between the breakouts. In the weeks to come, we'll reflect on the meeting and report on some of our sessions both to reinforce take-aways and to share with those who couldn't attend.

Thanks to all who made it. Here's a look at our opening video for the meeting a montage of people from hospitals and health systems in Vermont: https://youtu.be/HL9TyJgxqRc .
Jeff Tieman
VAHHS President and CEO
In the News
Porter prioritizes new services, building in 5-year plan
John Flowers , Addison Independent

Porter Medical Center leaders have drafted a five-year vision for the county’s hospital that among other things calls for new services, including women’s breast care and a pain clinic, a new medical office building, and a concerted effort to attract and retain workers in what is a particularly challenging labor market.

Dr. Seleem Choudhury, Porter president, discussed the strategic plan and his organizational aspirations during a Monday interview with the Independent.

It’s a potentially transformational time for Porter Medical Center, which encompasses the hospital, Helen Porter Rehab & Nursing, and around a dozen affiliated provider practices.

How To Teach Future Doctors About Pain In The Midst Of The Opioid Crisis
N ell Greenfield boyce , VPR

The next generation of doctors will start their careers at a time when physicians are feeling pressure to limit prescriptions for opioid painkillers.

Yet every day, they'll face patients who are hurting from injuries, surgical procedures or disease. Around 20% of adults in the U.S. live with chronic pain.

That's why some medical students felt a little apprehensive as they gathered recently for a mandatory, four-day course at Johns Hopkins University in Baltimore home to one of the top medical schools in the country.

The subject of the course? Pain.

Robot helps orthopedic surgeons at Copley Hospital
Erin Brown, WCAX

It's been about two years in the making, but Copley Hospital is finally introducing its newest piece of technology: a robot that assists with knee replacement surgery.

The robot is part of the NAVIO Surgical System. Doctors say it provides another way for surgeons to achieve technical accuracy and precision for partial and total knee replacement procedures.

Two of the Mansfield Orthopedic fellowship-trained orthopedic surgeons, Dr. Brian Aros and Dr. Nicholas Antell, are currently training with the robot.

On Monday they allowed WCAX News into the operating room for an exclusive femur bone removal demonstration and explained how the technology works.

Vermont sees spike in stimulant abuse, prescriptions
Xander Landen , VT Digger

Vermont is seeing a spike in stimulant drug abuse and prescription use, a trend that has policymakers and officials worried that the state could soon face a deepening drug crisis. 

Lawmakers on the state’s Joint Legislative Justice Oversight Committee asked health department and public safety officials to testify about stimulant use in Vermont this week amid concerns of rising methamphetamine abuse in the region and across the country. 

But while the Vermont Department of Health says that meth use in the state remains low, in a report presented to lawmakers, it says that the use of other stimulants, including cocaine and prescription drugs, is increasing.

Vermont has high rate for mental health conditions
V ermont Business Magazine

More than 90 percent of people who died by suicide showed symptoms of mental health conditions, yet 59 percent of US adults with a mental health condition received no mental health services in the past year, according to a new QuoteWizard.com report. States with a high rate of access to mental health care tend to have low prevalence of mental illness, Vermont was nearly opposite. The state has high incidence of mental health conditions (7) and also a high rate of access (2). Vermont also has a growing rate of suicide.

QuoteWizard, a LendingTree company, and one of the nation's leading online insurance marketplaces, released its report on how mental health care access across the country affects mental illness and suicide rates to bring awareness for National Suicide Prevention Week: Sun, Sep 8, 2019 – Sat, Sep 14, 2019, and September Suicide Prevention Month.

Blue Cross, MVP accept (slightly) smaller premium increases in 2020
Stuart Ledbetter, My NBC 5

Vermont's largest health insurance companies Blue Cross-Blue Shield and MVP have decided not to appeal orders from state regulators lowering premium increases in 2020.

The Green Mountain Care Board's decision allow most -- though not all -- of the insurers' double-digit price hikes.

The board allowed Blue Cross to raise prices 12.4% down from 14.4%. MVP's average premium will rise 10.1% down from 10.9%

Monday was their final day to appeal. 

The increases will be reflected on insurance policies sold on the state health care exchange, Vermont Health Connect, starting in January, 2020.

GMCB holds hospital budgets under targets, total increase 4.3 percent
Timothy McQuiston, Vermont Business Magazine

The Green Mountain Care Board announced today it has approved Fiscal Year (FY) 2020 budgets for Vermont’s 14 regulated hospitals. The Board provided the hospitals with instructions outlining budget parameters and submission guidelines that included a target of 3.5 percent for growth in net patient revenue from the FY 2019 base to FY 2020 budgets. The GMCB approved an estimated weighted average increase in hospital charges of 3.1 percent. The Board also reduced the system-wide increase in net patient revenue from a requested 4.6 percent to 4.3 percent, totaling a $7.3 million difference.

The Board will issue written hospital budget decisions and orders no later than October 1, 2019. 

The GMCB held a series of public meetings, and after a thorough review of the budgets by the Board’s staff and input from the Office of the Health Care Advocate and Vermonters.

Vermont rejects settlement offer from makers of OxyContin
Vermont Business Magazine

Vermont Attorney General TJ Donovan issued the following statement today regarding the state's decision to reject an offer by the Sackler family, owners of Purdue Pharma which markets the pharmaceutical opioid OxyContin:

"The State of Vermont rejected the settlement offer from Purdue Pharma and the Sackler family for the following reasons. First, the offer is not fully developed and we want to be certain that any benefit is not illusory. The value of the settlement is not fully guaranteed. It has been reported that the total value of the offer is $10-12 billion. That is incorrect. Only a fraction is guaranteed. Vermont demands more certainty and guarantees regarding the money in order to effectively address the opioids crisis in Vermont.

"Second, I do not believe that going to bankruptcy court to create and spin-off a new, public benefit company is in the public’s interest. I would prefer to shut down the company, sell the company’s assets now, and put the proceeds to use helping Vermonters whose lives have been ruined.

"Third, I want to be sure that billionaires can’t use bankruptcy court as a vehicle to avoid accountability.

"I believe in due process. I believe in the rule of law. But I also believe that the story needs to be told about how this epidemic started. For those reasons, Vermont rejected the settlement offer and will continue to fight on behalf of Vermonters."

Scott rejects regulators’ ask for Medicaid funding boost
Xander Landen, VT Digger

Gov. Phil Scott is rejecting a push from state regulators to dramatically increase Medicaid funding, disputing their argument that the underfunding of the program is the reason for rising commercial insurance rates. 

Last month, Kevin Mullin, chair of the Green Mountain Care Board, which regulates Vermont health care spending, urged Scott to include more Medicaid funding in the budget he will present in January. 

In a letter, Mullin told the governor that the state needs more funding to help address the Medicaid “cost shift,” which occurs when hospitals increase revenue from patients with private insurance to offset insufficient Medicaid reimbursements. 

He said that in previous years, the state’s Medicaid program has seen saw larger, more regular funding increases.

In less than a week, number of vaping related cases grows to 4
Ellie French, VT Digger

The Vermont Department of Health has opened investigations into four possible cases of vaping-related respiratory illness. But as recently as a week ago, that number stood at just one.

Of the four cases, state epidemiologist Patsy Kelso said, two involved adults (people over 18), and two involved minors. She said the department has also determined that one of the cases did not fall under the guidelines for what constitutes a vaping-related severe respiratory illness, though she couldn’t give specifics as to why.

“There’s certain criteria it needs to meet in order to be counted as a confirmed or probable case,” Kelso said. “The case definition includes a history of vaping in the past 90 days, as well as very specific findings on either an X-ray or a CT scan, along with other clinical criteria.”

The Health Department put out the official call for health care providers to report suspected cases of the illness on Aug. 29. The reports of suspected cases began that date, though officials are also looking back through medical records to try to determine possible earlier cases.

Health Care: See Where The 2020 Democratic Candidates Stand
Danielle Kurtzleben, NPR

Health care helped propel Democrats to victory in a wave of elections in 2018, and it remains a top issue for voters heading into 2020.

But the conversation has changed over two years; while in the last midterms health care debates revolved around protecting the Affordable Care Act, also known as Obamacare, after GOP attempts to repeal it, presidential candidates ahead of 2020 are focusing more on overhauling the entire health care system.

Incorporating a public option, where the government provides a form of insurance coverage the public can buy, was once a relatively progressive position within the party. Now, it has become a relatively moderate position compared to the push for single-payer, government-run health insurance.

That debate has sparked multiple policy questions, such as what role private insurance should play. In addition, candidates have been debating other ways to keep costs down, particularly in the area of prescription drugs. Here are where the current Democratic candidates stand across five health care policy areas.

Vermont AG joins coalition asking court to block refusal-of-care rule
Vermont Business Magazine

Attorney General TJ Donovan today joined a coalition of 26 public jurisdictions and health care providers in filing a motion for summary judgment (link is external), requesting that the US District Court for the Southern District of New York block the US Department of Health and Human Services’ (HHS) refusal-of-care rule. The rule seeks to expand the ability of businesses and individuals to refuse to provide medically necessary health care services on the basis of a business' or an employee’s own “religious beliefs or moral convictions.”

“Vermonters deserve access to high-quality health care that is free from discrimination,” said Attorney General Donovan. “The impact of HHS’s unconstitutional refusal-of-care rule would have devastating consequences and disproportionally impact women and marginalized patients, including LGBTQ+ patients. My office has been, and remains, committed to protecting access to health care for all Vermonters.”

National group seeks to rally businesses behind Medicare for All
Anne Wallace Allen, VT Digger

Business for Medicare for All, a national group that launched this summer to promote the kind of single-payer plan introduced by Sen. Bernie Sanders, has hired a Vermonter as its first employee. 

Dan Barlow, the former policy manager for Vermont Business for Social Responsibility, started in August as executive director of the new nonprofit. The group now has 350 members, and Barlow’s goal is to have 10,000 businesses from all 50 states signed up by January 2021.

Businesses typically pay about $6,000 annually for an individual or $20,000 for a family plan, Barlow said. Average family premiums have increased 55% since 2008, rising twice as fast as earnings and three times as fast as inflation, according to the Kaiser Family Foundation.

The new group is aimed at businesses of all sizes and types.

“We have folks who are sole proprietors who buy their own health insurance; we have folks who have been running a manufacturing company for decades and have seen how health insurance has eaten into their profits and wage increases,” Barlow said.

People in the News
Mark Your Calendar
Webinar
Tuesday, September 17

Northeast Kingdom Community Action Parent Child Center, St. Johnsbury
Monday, September 23

Milne Public Library, Williamstown, MA
Wednesday, September 25