State officials say the likely demise of a single payer health care system doesn't mean that the 2015 Legislature won't take significant steps to make health care more accessible and more affordable for many Vermonters.
Al Gobeille is the chairman of the Green Mountain Care Board, the body that oversees virtually every aspect of health care in Vermont.
He wants to move the state away from the current payment system known as "fee for service" and towards a system where health care providers are reimbursed based on the quality and not the quantity of their care.
"The way we pay right now actually doesn't get us the quality that we want,” said Gobeille. “If you look at measures of our state and our nation across the globe we don't always win. And so if we can pay for things differently, and put the incentives in the right place for physicians and health care providers, we could build a better system of care."
"If we can pay for things differently and put the incentives in the right place for physicians and health care providers, we could build a better system of care." - Green Mountain Care Board chairman Al Gobeille
Gobeille is hoping to have a comprehensive payment reform system in place by 2017.
Another key health care issue that's drawing a lot of attention at the Statehouse is what's known as the Medicaid and Medicare "cost shift." On average, Gobeille says Medicaid reimburses private health insurance companies at roughly 40 percent of the cost of the service and Medicare pays at around 88 percent.
To make up the difference, he says private health insurance companies have to pay around 140 percent and it's estimated that this shift is responsible for between 15 and 20 percent of the cost of all private premiums.
Hinesburg Rep. Bill Lippert is the new chairman of the House Health Care committee.
"Resolving that issue is a matter of quality care and fairness to providers as well as a financial fairness,” said Lippert. “So that those who are buying insurance in the commercial market are not shouldering an undue or unfair share of the costs."
Gov. Peter Shumlin is expected to recommend a sizeable increase in the state's Medicaid reimbursement rate in his budget address on Thursday afternoon and any additional state money will be matched by the federal government. What's not known at this time is how the governor plans to pay for his proposal.
