Health economist Elliot Fisher tells House committee Vermont must strengthen state oversight, expand primary care to rein in costs

Summary

Doctor Elliot Fisher testified to the House Committee on Health Care that wide regional variation, market concentration, and weak primary care drive excess spending; he urged stronger, independent state oversight, all‑payer primary care strategies and faster action on savings identified in quality improvement work.

Doctor Elliot Fisher, a health policy researcher, told the House Committee on Health Care that Vermont faces an affordability and access crisis driven by wide variation in practice, market concentration and insufficient primary care.

Fisher said the state has “a great opportunity” because the Green Mountain Care Board has broad authority to control provider prices, but it lacks sufficient resources and, in his view, possibly the independent capacity to implement the kinds of systemwide reforms he recommended.

Fisher summarized three long‑standing findings from his work with the Dartmouth Atlas of Health Care: that evidence to constrain clinical decisionmaking is often inadequate; that patients’ preferences vary; and that most geographic differences in spending are driven by how much care the system delivers rather than by patient need. “There are 10‑fold differences” in rates of some procedures across regions, he said, and much of the excess…

Health economist Elliot Fisher tells House committee Vermont must strengthen state oversight, expand primary care to rein in costs

Summary

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