AHS tells lawmakers it supports Sections 8–9 of statewide health care delivery bill; signals timeline, collaboration with GMCB

Bridal Krause, Director of Healthcare Reform at the Vermont Agency of Human Services (AHS), and Sarah Rosenblum, Deputy Director of Healthcare Reform, told a legislative committee that AHS is "generally ... very supportive of the content in both sections 8 and 9" of H.126/S.126 and that the proposal aligns with work the agency is already doing.

Krause and Rosenblum framed the bill’s statewide health care delivery plan as an inclusive, iterative exercise that should span hospitals, designated agencies, primary care, home health and hospice and other parts of the system rather than focus only on hospital regulation. Rosenblum told lawmakers that the bill’s timeline includes an interim reporting milestone: "the intention of the date that's there, which is 11/15/2025, was from this, like, AHS should be reporting back sooner rather than later," and that the advisory role described in section 9 is intended to monitor and evaluate benchmarks and measures.

Why it matters: Committee members repeatedly pressed AHS about speed and scope amid what several called a health care crisis in Vermont. The bill’s provisions — discussed in the hearing as potentially including reference-based pricing, hospital global budgets and other payment reforms — would affect how care is paid for and organized statewide and would require coordination between policy levers AHS controls and the Green Mountain Care Board’s regulatory and rate-setting authority.

AHS officials said they are already running short-term transformation and technical-assistance work and that the proposed statutory language is largely consistent with that ongoing work. Rosenblum said the legislation would provide the committee and the Legislature more formal oversight and transparency over a process AHS currently conducts, and she described the statewide plan as iterative rather than a one-time "waterfall" deliverable.

Committee members asked whether AHS or the Green Mountain Care Board (GMCB) has authority over the other. Krause and Rosenblum said neither agency has regulatory authority over the other; instead, they described a collaborative relationship in which AHS brings policy and payment levers and GMCB brings regulatory and rate-setting levers. Rosenblum said the plan is intended to be inclusive of hospitals but to extend beyond them.

Lawmakers pressed for clarity on where benchmarks, monitoring and reporting should live. AHS suggested that the advisory committee laid out in section 9 would evaluate and monitor implementation and that the detailed benchmarks and measures would be developed collaboratively, with some discussion in the hearing about whether the writing group (section 8) or the advisory committee (section 9) should set them.

Members also asked about scope items raised during questions: primary care restructuring (AHS said this is a substantial and active part of current technical assistance and planning), correctional health care and the Medicaid waiver (AHS said there is overlap and that staff will follow up with specifics), and the bill’s funding needs (AHS acknowledged existing base funding for the Office of Healthcare Reform and said the bill’s language contemplates support for a future state of work that may require additional appropriations).

Several committee members voiced urgency and concern about implementing payment reforms quickly and correctly. Rosenblum acknowledged the tension between immediate crisis responses and longer-term planning and described the plan as something that would change as circumstances and measures evolve. She told the committee that AHS participates in weekly short-term transformation meetings and will present more implementation detail in related testimony the following day.

The hearing did not record any formal votes. Lawmakers and AHS staff agreed on the need for continued oversight, iterative review, and coordination across agencies and providers as the statewide plan is developed.

The committee scheduled additional testimony on related transformation and implementation work for the next day.