Vermont’s Super MedPAC

While Washington continues to debate the federal IPAB, Vermont has now passed a much more powerful version at the state level, the Green Mountain Care (GMC) Board.  Among its powers (18 VSA §9375) are rule making authority that IPAB can only dream about:

Implement by rule, pursuant to 3 V.S.A. chapter 25, methodologies for achieving payment reform and containing costs, which may include the creation of health care professional cost-containment targets, global payments, bundled payments, global budgets, risk-adjusted capitated payments, or other uniform payment methods and amounts for integrated delivery systems, health care professionals, or other provider arrangements.

Notice the absence of exceptions for doctors and hospitals. Rate setting figures prominently:

Set rates for health care professionals [including drugs and devices] pursuant to section 9376 of this title, to be implemented over time, and make adjustments to the rules on reimbursement methodologies as needed.

They also have oversight review for:

  • Benefit packages;
  • Insurance rate increases;
  • Hospital budgets;
  • CONs; and
  • Quality and performance outcome measures

Fun fact:  the Chair of GMC board is paid $116,688 (plus free health care!)  (Sec 33a)

Update:  This post is part of a series on Vermont’s single payment system law.


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