Senate Health and Welfare debates changes to statewide health‑care delivery bill, budgets and data rules

At a meeting of the Senate Health and Welfare Committee, staff and stakeholders reviewed and revised the committee’s draft health‑care delivery bill, focusing on hospital budget review, hospital network oversight, statewide health‑care delivery planning, data integration and proposed staffing and appropriations for implementation.

The discussion centered on how much authority the Green Mountain Care Board (the board) should retain; how hospital budgets and hospital‑network finances should be reviewed; whether global hospital budgets should begin in fiscal year 2028 or later; how Medicare and Medicaid should be carved out; and how to structure an advisory committee and data governance. Committee staff indicated they will produce a new draft for the committee’s next meeting.

Committee staff advised against broad statutory edits to the board’s general rate‑setting authority outside the bill’s reference‑based pricing context, saying such changes would be a “whole other discussion.” Members and staff debated whether language describing the board’s duties (including participation in federal programs) should be narrowed or left unchanged while the committee proceeds with the bill’s immediate reforms.

On budget review, staff proposed removing some prescriptive ‘‘uniform system of accounts’’ language and instead using less prescriptive, standardized approaches and a consultative review process for hospital budget data submissions. The committee discussed shifting provisions related to hospital networks to a separate section addressing network financial operations rather than treating them the same as individual hospital budgets.

The committee considered a set of proposed changes to incentives and revenue accounting. One option discussed was excluding revenue derived from community‑support programs from net patient revenue and total cost‑of‑care targets. Committee members discussed moving any requirement…