Conference committee advances broad healthcare plan, adds advisory and steering committees and new reporting requirements

Committee members continued a conference committee on the fiscal/health bill for 2026, discussing several sections that add advisory bodies, require new reports and timelines, and direct short-term hospital-spending reductions.

The committee considered adding a statewide Health Care Delivery Advisory Committee, creating a Comprehensive Primary Health Care Steering Committee with representation from primary care and allied professions, and ordering multiple reports and updates from the Agency of Human Services (AHS) and other agencies on data integration, hospital spending reductions and insurer stability.

The changes to Section 9 would add a Health Care Delivery Advisory Committee with purposes that include establishing health care affordability benchmarks, evaluating and monitoring system performance and leading development of a statewide health care delivery strategic plan. Committee members debated the advisory committee's membership: the Senate version listed 14 members while the House expanded the roll to include a member of the Health Equity Advisory Commission, separate representatives for physicians and independent physician practices, an advanced practice registered nurse chosen by the Vermont Nurse Practitioners Association, a small-business representative selected by the Vermont Chamber of Commerce and an executive director (or designee) from the Vermont Program for Quality Health Care (VPQHC). The House language also specifies that members shall not receive per diem compensation or reimbursement of expenses.

On the Comprehensive Primary Health Care Steering Committee, the committee discussed the proposal to create a 16-member steering body to inform state government, the Blueprint for Health and the Office of Health Care Reform on primary care access, delivery and payment. A committee member who identified the section as their addition said the steering committee is intended to give primary care a larger role than it has had on smaller advisory groups and to eventually "repeal and replace" existing primary-care advisory bodies such as the Green Mountain Care Board's Primary Care Advisory Group (PCAG) and the Blueprint advisory committee. The steering committee's duties would include ongoing assessment of primary care needs, workforce recommendations, proposals for sustainable payment models, strategies to reduce administrative burden, and consultation with the Green Mountain Care Board on reference-based pricing for primary care.

The committee spent substantial time on data integration language. The Senate draft would add a statutory requirement directing AHS to collaborate with the Health Information Exchange steering committee to develop an integrated statewide system of clinical and claims data, require insurers to provide data and require AHS to provide access to state agencies and providers where data-use agreements allow. The House substituted a one-time report: AHS would evaluate the feasibility, privacy and security safeguards, potential uses and expected value of an integrated clinical-and-claims system and submit findings by Jan. 15, 2026. The House language also specifies that AHS shall not begin implementing an integrated statewide system unless directed by subsequent legislation.

Committee members highlighted provider testimony that clinicians most need near-real-time clinical interoperability (being able to see where patients received care and test results inside providers' existing electronic health records) rather than an initial combined clinical-claims repository. Several members urged the conferees to review previously negotiated compromise language produced by AHS, the Green Mountain Care Board and the Office of the Health Care Advocate before finalizing the approach.

Sections 11a and 11b were presented as urgent, near-term measures aimed at reducing hospital spending for hospital fiscal year 2026. Section 11a directs AHS to facilitate collaboration among hospitals to identify efficiency and quality opportunities and to supervise participation to protect against antitrust concerns, with a legislative expectation of reducing hospital spending by at least 2.5% for hospital fiscal year 2026. The bill would require AHS to report proposed approved reductions, timing and accountability measures to the Health Reform Oversight Committee (HROC) and the Joint Fiscal Committee by July 1, 2025, and to provide monthly updates beginning Oct. 1, 2025, while the hospitals implement FY2026 budgets that begin in October.

Section 11b would require AHS to identify outcome measures tied to the five goals from Act 167 (reduce inefficiencies, lower costs, improve health outcomes, reduce health inequities and increase access to essential services), report the measures and timelines by July 1, 2025, and provide monthly updates beginning Aug. 1, 2025. Committee members discussed folding the Act 167 evaluation and the strategic-planning work together to avoid duplicative reports.

The committee also proposed a short-term grant program under Section 11c: AHS would award up to $2,000,000 (identified in the bill as coming from HIT-related funds) in grants during state fiscal year 2026 to hospitals that actively participate in transformation efforts, with funds distributed on a first-come, first-served basis and an obligation report due to HROC and the Joint Fiscal Committee by Nov. 15, 2025.

Section 11d asks the Department of Financial Regulation to provide HROC a plan by Nov. 1, 2025, to preserve sustainability of domestic health insurers, which could include reinsurance or other mechanisms. Other sections clarified that the Green Mountain Care Board may share subpoenaed materials with AHS and the Department of Financial Regulation as appropriate, and that authority to preserve accountable care organization (ACO) capabilities and related implementation reporting is assigned to AHS.

Multiple members cautioned about the volume and cadence of reports: the House substitutes several study-and-report provisions for the Senate's codified duties, and members repeatedly noted that AHS and hospitals are already stretched. Several conferees suggested consolidating reporting requirements into existing plan reports where feasible.

No formal votes or final actions were recorded in the portion of the transcript provided; the conferees directed staff to revise language and to return with suggested amendments and timing clarifications. The committee scheduled a brief follow-up meeting to continue negotiations.

Ending: The conference committee produced a package of negotiated changes that expand advisory representation for health care affordability and primary care, order feasibility work on data integration rather than immediate implementation, and set specific near-term targets and reporting timelines for hospital spending reductions and insurer sustainability. The conferees left open multiple technical details—membership lists, exact report schedules and whether some advisory bodies will be merged into the new steering committee—and asked staff to bring revised language at the next meeting.