The Vermont Senate accepted the committee of conference report on S.126, an act to reform health care payment and delivery, after committee leaders outlined agreed changes and implementation timelines.

The bill tasks the Green Mountain Care Board with authority to pursue reference-based pricing and global hospital budgets beginning in 2027 if resources are available, directs development of a statewide health care delivery strategic plan, creates a Vermont steering committee for comprehensive primary health care, and provides targeted grants and reporting requirements to support interoperability and cost-containment work.

Senator from Chittenden, reporting for the Committee of Conference, said the conference committee’s agreement preserves the Senate’s core policy aims while incorporating some House changes. He said section 2 assigns duties to the Green Mountain Care Board, including authority to establish both reference-based pricing and global budgeting beginning in 2027 and continuing through the implementation window described in the bill. The reporter said reference-based pricing discussions referenced Medicare as a potential benchmark but also allowed additional benchmarks where appropriate.

The bill defines “hospital network” and standardizes hospital budget submissions and reviews. Section 5 requires the Green Mountain Care Board to consider the statewide health care delivery strategic plan when reviewing hospital budgets and to look at administrative-to-direct-care staffing ratios and executive and clinical leadership compensation. The reporter told senators the Board may recommend (language reconciled between chambers) actions to correct network or financial operations inconsistent with reform principles.

The conference agreement also creates a 16-member Vermont steering committee for comprehensive primary health care to assess workforce needs, recommend recruitment and retention strategies, propose sustainable primary care funding models, identify ways to increase access and reduce administrative burden, and advise on reference-based pricing for primary care. The reporter described the steering committee as intended to complement existing advisory bodies such as the Blueprint executive team and the Green Mountain Care Board’s advisory work.

On data and interoperability, the bill directs work toward a unified health data space to improve clinical-data interoperability among providers and timely patient access to clinical data. The conference report includes $2 million from an existing health information technology fund to provide incentive grants to hospitals to engage in transformation efforts, expand telehealth, and improve interoperability.

The bill also requires a series of reports: updates on health care spending reductions and transformation (including alignment with Act 167 work), a Department of Financial Regulation report on domestic insurer sustainability, Green Mountain Care Board reporting on reference-based pricing and global budget effects, and an Agency of Human Services report tied to implementation work. Effective dates in the report include immediate effect on passage for most sections, with targeted reporting and appropriation provisions taking effect July 1, 2025, and other deadlines specified in the conference text.

During floor discussion Senator from Orleans praised the interoperability and electronic medical record provisions as a step toward statewide efficiency that could save hospitals money. In response to a question from Senator from Rutland about reimbursement benchmarks, the Committee reporter said Medicare-based multiples (for example, roughly 250–300% of Medicare for some reference-based pricing arrangements) were discussed as possible targets, though reimbursement varies widely by service and provider.

The Senate voted to accept and adopt the committee of conference report on S.126; the transcript records the ayes prevailing and the report adopted. The conference reporter urged support, noting the bill’s combination of cost-control tools, data integration work, and primary-care-focused governance structures intended to protect access while addressing hospital affordability and system sustainability.

Implementation will require the Green Mountain Care Board, Agency of Human Services, Department of Financial Regulation, and participating hospitals to follow the statutory timetable and reporting requirements in the enacted text.