[{"_1":2,"_99":-5,"_100":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,75,87],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},"mediaId",6058557,"mediaKeyId","3297054-71918be456df52ac34216b0fa2d97a26","parentId",3297054,"title","Students find Vermont hospital price and quality tools inconsistent; propose standardized dashboard and incentives","audioSeconds",846,"startMs",1519000,"endMs",2365000,"viewUrl","/Search/View?dp=1&key=3297054-71918be456df52ac34216b0fa2d97a26&start=1519&end=2365","thumbnailUrl","https://assets.pipeline.soar.com/3297054-71918be456df52ac34216b0fa2d97a26/thumbnail_1519000.jpg","articleUrl","/articles/6058557/Vermont/Students-find-Vermont-hospital-price-and-quality-tools-inconsistent-propose-standardized-dashboard-and-incentives","mediaUrl","https://secure.pipeline.soar.com/6058557-391f1c562052bc49b9e3c86e1c9cc698/orig.mp4?Expires=1771148378&Signature=S6hJQnXaEav9w8UvWW-ZVdoxp87Wf-mWkFddemViFdwUVH7xp1ndlWK50d~at8KMKaADxqt7WiFlxmlb9v1cQcknTtT8sHuzTK54lNIDp9j8nOyQdPtiFfcGgbJ9yp1xYds2LiJ5yOVqNgvzcOhKE23zZN78OI0JpLYJRJruoFbO6bm3j5wVBsdMexICjvxKFgy045w0STmw3ybi~oYeJtJt5ZZD74aA9rX5ulVjb3I9wNRWQ2TbCyzI~3f9UjXQhBw7kCR0DyBD58u4~8ECZvuTGJrpZHbhfDE5fA7yp65Ak9OOJd8HzOBfqgCQwg28gXzKGmj1Vo~AJyDj2G7Qjw__&Key-Pair-Id=KUT5TJCACFTXG","author","","date","2025-05-15T02:33:30Z","article","Three Middlebury College students told the Vermont House Health Care Committee on May 14 that federal and state price‑transparency rules have not produced useful, comparable data for Vermont patients, and they urged the committee to support a standardized state dashboard and stronger enforcement.

The students said they reviewed hospital price files and consumer tools and found widely variable formats, frequent gaps and outdated files. They showed examples: a hospital machine‑readable file described as effectively unusable without spreadsheet expertise; a price estimator that excluded separate physician charges; and another hospital tool that presented clearer patient‑facing prices but was not comparable across hospitals.

Student presenters said Vermont health‑care spending was about 22% higher than the U.S. average in 2020 and that disparity makes actionable transparency more urgent. They noted a 2023 study finding only 29% of hospitals were compliant with the federal hospital price‑transparency rule, despite possible fines. The students produced a comparison of a single shoppable service — a standard colonoscopy — and reported negotiated Blue Cross Blue Shield estimated rates ranging from about $1,400 at one lower‑cost hospital to about $8,000 at UVM Medical Center.

They highlighted New Hampshire’s HealthCost website as a working model that combines negotiated price estimates and comparable quality measures; presenters said the New Hampshire site receives about 75,000 visits per month and provides side‑by‑side price and quality comparisons. The students proposed three measures for Vermont: 1) form a hospital working group and set a standardized, consumer‑friendly data format and list of quality metrics; 2) use the Green Mountain Care Board’s hospital budget review process to enforce compliance and consider state fines for noncompliance; and 3) build a public price‑and‑quality dashboard that includes insurer filters and accessibility features and pair it with a “smart shopper” rebate program or a right‑to‑shop law so patients (and insurers) share savings.

Committee members asked about including nonhospital providers, how ordering and follow‑up would work across institutions, and what quality metrics (patient satisfaction, readmission, infection rates) should be prioritized. Presenters said quality data in Vermont are often sparse because small hospitals have small sample sizes and Care Compare may suppress metrics that are not statistically meaningful; they recommended rolling multi‑year averages to increase sample sizes.

The committee took no formal action at the session. The students provided a handout comparing laws and tools and said they would share a mock‑up dashboard they made as an example for legislators and regulators.","mediaType","Video","parentTitle","House Healthcare - 2025-05-14 - 9:00 AM","oneSentenceSummary","Middlebury students told the House Health Care Committee May 14 that Vermont hospital price and quality transparency is fragmented and difficult for consumers to use; they recommended a standardized reporting format, a public dashboard like New Hampshire’s, and consumer incentives to ‘shop’ for care.","taxTitle","Health Care, HOUSE OF REPRESENTATIVES, Committees, Legislative , Vermont","taxId",30956,"location","Vermont","headline","shortSummary",{"_33":76,"_35":36,"_37":38,"_39":77,"_41":78,"_43":79,"_45":80,"_47":81,"_49":82,"_51":83,"_53":84,"_55":56,"_57":58,"_59":85,"_61":62,"_63":64,"_65":86,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},6058561,"Student warns private equity acquisitions can harm care quality, urges CPOM and transaction review in H.71",1305,55000,1360000,"/Search/View?dp=1&key=3297054-71918be456df52ac34216b0fa2d97a26&start=55&end=1360","https://assets.pipeline.soar.com/3297054-71918be456df52ac34216b0fa2d97a26/thumbnail_55000.jpg","/articles/6058561/Vermont/Student-warns-private-equity-acquisitions-can-harm-care-quality-urges-CPOM-and-transaction-review-in-H71","https://secure.pipeline.soar.com/6058561-6660fa37942b0a8fecbece57901b019c/orig.mp4?Expires=1771148378&Signature=IytWFWZjwcmKmk4LfUGrO-0PP0OljRkh7Nqa4hZAKvvA0eig8zXUDYV0Shzfh~HYXrZZ~FG7sf87mMzZuzkJufAmUFmBWtBrJTioOm2mkdFq5yN-OPW7HRd3IdVUh49zdLZ64sKKHkiNDkT1tjgRmmjUEKjUSoxSgOw6AY4INVIh-gHkpfVXHENCuAEdUWGh0UtXW5OjjUUzNNcZo9~-MtIyQiFSjgmwZfCaXWzXCCzimk0HqpCt9JOA3-0UEZYIJ6a899EmLY2jOoszKIkm1IPZBwNUKETCUTuTK~Tp6Tux9a55F86chcvu9cKIMImFqTldEHrISS7~jH1jQ1bx0Q__&Key-Pair-Id=KUT5TJCACFTXG","Jonathan Brooks, a Middlebury College student, told the Vermont House Health Care Committee on May 14 that growing private equity investment in health care nationally and in Vermont raises risks for quality, price and financial practices, and that lawmakers should incorporate corporate practice of medicine protections and stronger transaction review into Vermont’s H.71 bill.

Brooks summarized peer‑reviewed studies and interviews his group conducted and cited data showing increased adverse events and price increases after private equity acquisitions in some cases. He said some studies reported a 20–25.4% rise in hospital‑acquired conditions, a roughly 27.3% increase in patient falls and around a 37.7% rise in central line‑associated bloodstream infections in hospitals acquired by private equity. For nursing homes, he said some studies showed “up to an 11% increase in mortality.” He also cited a study finding about a $407 increase in total charges per inpatient day in acquired hospitals and average increases in outpatient specialty practice prices.

Brooks described business practices that can drive those results: consolidation and “roll‑ups” that can reduce competition, and financing arrangements that extract cash through monitoring fees, lease payments or interest. He cited a 2021 review (Gupta et al.) that identified monitoring fees, lease payments and interest as sources of increased costs after private equity takeovers.

He reviewed legislative models from other states. He said California Senate Bill 351 attempts to prohibit interference with clinical judgment and would make certain non‑compete and gag clauses unenforceable and give the attorney general enforcement authority. He said Massachusetts H.5159 requires ownership disclosure, cost and market impact reviews, and post‑transaction monitoring; he noted that Massachusetts’ law is already enacted. Brooks said Vermont’s H.71 contains corporate‑practice‑of‑medicine provisions, transparency requirements, limits on debt levels and whistleblower protections, but he recommended the bill be strengthened by explicitly listing prohibited management powers and by implementing a standardized front‑end screening (cost and market impact review) modeled on Massachusetts to flag risky acquisitions before they close.

Brooks argued these measures are warranted because private equity has expanded substantially over the last two decades and because Vermont ranks higher on private‑equity risk measures: he said a private equity risk index rates Vermont about 46 out of 100 overall and about 66 out of 100 on the health‑care subindex, which he attributed in part to the share of nursing homes under private ownership and the absence of corporate practice of medicine laws in Vermont.

When lawmakers and committee members asked follow‑up questions, Brooks described limits of the evidence—he acknowledged the literature is mixed, with some reports showing improved outcomes in some private‑equity‑owned hospitals—but emphasized the need for statutory guardrails to preserve clinical independence and long‑term stability.

No formal committee vote was taken. Brooks provided the committee with a handout comparing bills and asked lawmakers to consider tightening H.71 language to add explicit prohibitions on managerial control over clinical matters and a standardized acquisition screening process.","A Middlebury College presenter told the House Health Care Committee May 14 that rising private equity activity in health care can worsen quality and increase prices, and recommended corporate‑practice‑of‑medicine protections and standardized acquisition reviews be added to Vermont’s H.71.",{"_33":88,"_35":36,"_37":38,"_39":89,"_41":90,"_43":91,"_45":92,"_47":93,"_49":94,"_51":95,"_53":96,"_55":56,"_57":58,"_59":97,"_61":62,"_63":64,"_65":98,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},6058564,"Students urge PBM and 340B transparency, propose 20% cap on hospital drug markups",1115,3260000,4375000,"/Search/View?dp=1&key=3297054-71918be456df52ac34216b0fa2d97a26&start=3260&end=4375","https://assets.pipeline.soar.com/3297054-71918be456df52ac34216b0fa2d97a26/thumbnail_3260000.jpg","/articles/6058564/Vermont/Students-urge-PBM-and-340B-transparency-propose-20-cap-on-hospital-drug-markups","https://secure.pipeline.soar.com/6058564-0259be3b6f255defa301b8f0dddc4905/orig.mp4?Expires=1771148378&Signature=BJzjH0kiwgXOyKxwDHIKj1z5xhiYEdR1j8Ci6NlzQKbmL0bEWi5pv7PI0qaY6sf92jfJZgZaxK6qEVg1bkswUGQyIUlZPS55XXAXIenKZkNewHsWwXjY1goNgW59YJGgYYNiOvxq67P0~FcW~Qx8eQB3O1n68YB-tD95FWCMbIQL47-p5AEzE~8EIQX-GJ5VERdFNzivfvJ11oOoaWehQRI2VrO-NqkMrgc8i7rlqRbmIlJzc1zOFTP75Aq5eUIjjSohvLJ~BruaqMhuE20mnmRcWq2WjLWQFJYI3sab70BJJqxxyLYOF0-ADLd0ya80YeL71zhj7HeSeCuJxPgC7g__&Key-Pair-Id=KUT5TJCACFTXG","Middlebury College students told the Vermont House Health Care Committee May 14 at the State House that pharmacy benefit managers (PBMs) and the 340B drug-pricing program are contributing to high prescription costs and recommended state-level reporting and price limits.

The students said greater transparency and reporting from PBMs and hospitals would show where discounts and markups flow and help regulators spot “spread pricing” that diverts savings away from patients. They recommended requiring PBMs to submit an annual reimbursement report and hospitals to report 340B revenue and usage, then consider a 20% cap on commercial reimbursement for hospital‑administered drugs.

Student presenter Ellie Kennedy said PBMs “act as middlemen between manufacturers and pharmacies” and that their markups are often treated as trade secrets, making oversight difficult. She and her team highlighted state-level examples: Minnesota’s 2023 statute requiring 340B reporting and a Minnesota report that accounted for $630,000,000 in 340B revenue across covered entities. Kennedy said Minnesota’s experience shows both the value and the data‑collection challenges of such laws.

The students reported that Vermont hospitals’ administered drug prices are unusually high in national comparisons: a 2024 RAND chart the group cited places Vermont hospital‑administered prices at over 500% of the average sales price (ASP) benchmark used elsewhere. The group gave a concrete example: they said Blue Cross Blue Shield of Vermont must reimburse Rutland Regional Medical Center more than 1,400% of ASP for the drug Remicade under commercial contracts cited in their research.

To detect and limit abusive pricing, the students proposed: (1) specific 340B reporting language that includes drugs “dispensed and administered to patients,” to avoid the undercounting Minnesota experienced; (2) mandatory, standardized PBM reimbursement reports to the Department of Financial Regulation as a condition of licensure, including median reimbursement rates and any differential treatment of 340B claims; and (3) a 20% cap on hospital‑administered drug markups for commercial insurers, noting Medicare’s 6% benchmark and estimating that a 20% cap would still allow hospitals room to cover handling and administrative costs.

Presenters acknowledged tradeoffs. They said hospitals rely on some 340B revenue to fund services for low-income patients and that the state would need careful data collection and complementary health-care reforms. The students also noted that Blue Cross Blue Shield of Vermont projects most commercial savings from a cap would come from three hospitals: UVM Medical Center, Central Vermont Medical Center and Rutland Regional Medical Center.

Committee members and staff at the hearing asked technical questions about Minnesota’s methodology and how a Vermont reporting law would define reportable drugs and revenue. The students referenced ongoing state bills as models and said H.266 (a Vermont bill discussed elsewhere in the hearing) aims to address some 340B transparency issues.

No formal action was taken at the hearing; the committee will consider student testimony as it reviews pending legislation on 340B reporting and related PBM regulations.","Middlebury College students told the House Health Care Committee May 14 that Vermont should increase transparency of pharmacy benefit managers and 340B revenues and consider capping hospital-administered drug reimbursements to curb high prescription costs.","actionData","errors"]

Article not found

Students find Vermont hospital price and quality tools inconsistent; propose standardized dashboard and incentives

Student warns private equity acquisitions can harm care quality, urges CPOM and transaction review in H.71

Students urge PBM and 340B transparency, propose 20% cap on hospital drug markups