H.202 House Health Care
  March 20, 2011

• Green Mountain Care Board (to control health care cost growth)

• Vermont Health Benefit Exchange (to reform health insurance purchasing and administration, consistent with federal law)

• Green Mountain Care (to provide universal access and maximize cost savings)

• Responsible for Vermont’s health care system that currently lacks integration and systemic coordination.

• Independent from executive and legislative branches. Five members, nominated by a new Green Mountain Care nominating committee and appointed by Governor with consent of Senate

• Oversees and evaluates payment reform at all levels – primary care, specialty care, hospital care – aimed at moving from payment for volume to payment for value

• Builds on and maximizes savings from Blueprint (patient-centered medical home)

• Develops overall budgeting with a reasonable rate of growth

• Eliminates cost-shifting going forward

• Provides strategic planning for Vermont’s health care system through comprehensive data systems, adequate staffing and expert analysis

• Consolidates purchasing and simplifies purchasing of health insurance:

• Creates easy to access website for health insurance, one-stop-shopping

• Provides Vermonters with apples-to-apples comparisons

• Provides access to federal health insurance subsidies.

• Will ensure outreach to Vermonters and simple enrollment

• Acts as the "engine" of health care reform – implements payment reform and administrative simplification for as much of the population as possible

• Maximizes administrative simplification for patients, employers and providers

• A universal health care program providing health care to all Vermont residents including providing them access to primary care, preventative care, chronic care, acute care, and hospital services.

• Occurs after Affordable Care Act waiver is obtained and financing plan and budget are enacted into law.

• All Vermonters covered by virtue of residency with penalties for falsifying residency

• GMC board proposes three year budget that must be approved by legislature.

• Financing must maximize federal funds and spread costs fairly

• Integration and financing plans will address:

• What will the overall costs/savings be?

• How much federal $ will we get?

• How do we deal with border issues?

• How are public and private coverage integrated?