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Conference committee confronts future use of global hospital budgets and reference-based pricing timeline
Summary
Committee members debated language on whether the Green Mountain Care Board should report on reference-based pricing and whether the bill should end or consider future use of global hospital budgets; the Senate version delays global budgeting to a hospital fiscal year beginning in 2028 and the committee flagged consistency and timing issues.
Members of the health conference committee spent substantial time on language about global hospital budgets and reference-based pricing measures, as well as the timing of when any global budget approach would begin.
Jen Harvey told the panel the bill would add to the Green Mountain Care Board's annual report a required status update on reference-based pricing efforts. "This is adding to the Green Mountain Care Board existing annual report requirements to require the board to include the status of its efforts on reference based pricing," she said, and noted that the Senate version would also alter language on development or future consideration of global hospital budgets.
Committee members discussed competing House and Senate language. Harvey summarized: the Senate language directed an end to development of global hospital budgets, while the House language requires reporting "and any considerations regarding the future use of global hospital budgets." Another committee participant noted the Senate bill did not make global budgeting effective until a hospital fiscal year beginning in 2028.
A participant summarized how the appropriation and staffing pieces tied to reference-based pricing were intended to support future work: "And the contracts that are here were for reference based pricing so that they could get up to speed on what to do." Committee members noted the board had said it "would need to be positioned every year for a couple of years," indicating multi-year staffing needs for implementation.
Harvey flagged effective-date inconsistencies: section 16 (the Green Mountain Care Board report requirement) was noted to take effect on July 1, 2026, while sections 17 and 18 (positions and appropriations) should take effect July 1, 2025 (FY26). The committee agreed to fix the dates in the bill text.
The transcript does not show a final policy choice on whether to adopt global budgets, only that the Senate and House differ and the committee must reconcile language. Committee members identified global budgeting as a "huge" outstanding issue and said they would continue discussion in further sessions.
