Comments on the GMCB/UVMHN/UVMMC “Settlement” Proposal

Public Comment Green Mountain Care Board

Julie Wasserman, MPH
Health PolicyiAdvocacy i
TO: Green Mountain Care Board
RE: Comments on the GMCB/UVMHN/UVMMC “Settlement” Proposal
FROM: Julie Wasserman, MPH
DATE: March 28, 2025
___________________________________________________________________________
Summary:

UVMHN, UVMMC, and GMCB have drawn up a Proposal, in part, to avoid continued
litigation over UVMMC’s FY23 Budget Overage of $80M and UVMMC’s FY24 Budget
Overage of $53M. Please note: UVMMC’s FY25 first quarter spending already exceeds
its FY25 Budget Order. And UVMHN opposes the FY26 Hospital Budget Guidance of
holding operating expense growth at no more than 3% over its FY25 approved budget.
The Proposal’s primary components are three-fold:

1. UVMMC will contribute $11M in FY26 to non-hospital primary care providers.
2. UVMMC will pay BCBSVT $12M to resolve allegations of FY22 and FY23
overpayments to UVMMC.
3. UVMMC and/or UVMHN will spend up to a total of $15M on consultants and a
liaison “to help identity a path to maintain and improve access to high quality
healthcare services while improving affordability for Vermonters”.

First and foremost, the GMCB needs to ensure that its “public comment process” allows
for flexibility in the conditions of the Proposal and provides a genuine opportunity for
adjustments. Otherwise, why would the public bother to provide input?

A critical question: How does this Proposal affect Vermont’s most pressing problem of
affordability? This is an especially important question to ask at this moment because the
primary party to this Proposal is the entity who led Vermont into its affordability crisis.
The Proposal lacks any concrete initiatives to directly improve affordability. Surely not
the $15M for UVM’s consultants and liaison. Sadly, the word “affordability” is
mentioned only once in the Proposal and its wording could not be more vague and
nebulous: “to help identify a path to maintain and improve access to high quality
healthcare services while improving affordability for Vermonters”. Language to enforce
implementation of these goals is absent.

—  To address our crisis of affordability, a portion of the $53M should go toward rate
relief for Vermonters.
— The Proposal’s language needs to be strengthened to specify that reliable
mechanisms shall be implemented to improve affordability.

The Proposal’s Primary Components: continue reading here