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DVHA outlines Medicaid reference‑based pricing and hospital global‑budget evolution to the committee
Summary
Alicia Cooper of DVHA described Vermont's use of Medicare as a reference point for many Medicaid fee schedules, existing fixed‑payment ACO arrangements and a planned Medicaid hospital global budget methodology for 2026 to maintain revenue predictability for hospitals.
Alicia Cooper, director of managed care operations at the Department of Vermont Health Access, told the Senate Health and Welfare Committee that Vermont Medicaid already uses Medicare as the reference point for many fee schedules and that the department is working on hospital global budgeting.
Cooper said Medicaid fee schedules vary by service line but are commonly tied to Medicare: for example, clinical laboratory services are reimbursed at about 97.5% of the Medicare fee schedule in the current approach. She noted that…
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