Stakeholders Tell Senate Health & Welfare to Prioritize Primary Care; Raise Data and Oversight Concerns

At a Senate Health & Welfare Committee hearing, lawmakers heard detailed testimony on a proposed committee bill to create a statewide health-care framework, with witnesses pressing the panel to prioritize primary care funding for 2026 and raising concerns about data integration, payment reforms and new regulatory duties.

The testimony centered on three recurring points: an immediate funding gap for primary care after the end of the current all-payer arrangements, technical and privacy limits to proposed statewide data integration, and caution about expanding regulatory reviews of hospitals and adding staffing without redirecting funds to care delivery.

Devin Green, of the Vermont Association of Hospitals and Health Systems, said hospitals “want to be a part of the solution” but warned against some proposals in the outline. “We do not support the Green Mountain Care Report review of hospital strategic plans,” Green told the committee, saying detailed review of individual hospitals’ strategic plans would “have a chilling effect on our volunteer boards” and add administrative costs to an already lengthy budget process.

Jessa Barnard, executive director of the Vermont Medical Society, urged the committee to close an immediate funding gap she quantified for the panel: “There’s actually a $5,500,000 gap” for state fiscal year 2026 related to programs that supported primary care under the All-Payer Model, and she said Medicare’s temporary payments to the Blueprint for Health accounted for about “$10,800,000 in lost payments” unless federal participation resumes under the AHEAD model scheduled for 2027. Barnard and other primary-care advocates told senators those shortfalls could destabilize practices before new payment models take effect.

Insurer representatives also urged caution. Sarah Teachout of Blue Cross and Blue Shield of Vermont supported some elements such as reference-based pricing on a phased basis but objected to combining certain databases for clinical use. “The Medicare data cannot be combined with any other data,” Teachout said, and she described limitations in commercial claims coverage, governance complexity, privacy exposure and maintenance costs that reduce the value of integrating vCures into a clinical Health Information Exchange.

Testimony from several groups — including Vermont Health First, Bi-State Primary Care Association and the Health Care Advocate — endorsed an integrated statewide plan and evaluation process but repeated the call to protect near-term primary-care funding and workforce stability. Multiple witnesses recommended that any regulatory expansion focus on aligning incentives and measuring outcomes rather than imposing new, duplicative reporting burdens. Several speakers suggested repurposing staff and funds freed by the end of the All-Payer Model toward direct care rather than creating new oversight structures.

On payment reform, witnesses generally supported careful exploration of reference-based pricing, global hospital budgets and value-based payments but urged phased implementation, precise scope and federal coordination. Observers repeatedly warned that global hospital budgets and other reforms depend on Medicare and federal participation to reach the scale needed to change provider behavior; without that federal partnership, several witnesses questioned whether the AHEAD model or full global budgets would be viable.

Witnesses also asked the committee for clarity on specific items in the draft outline, including whether reference-based pricing would apply to outpatient hospital services only or to independent physician practices and other nonhospital providers; how benchmarks and payment calculations would be set; and what triggers would pause a policy if it failed to perform as intended. Barnard asked the committee to “build in triggers” to stop approaches that are not working and to allow reversion to prior arrangements if necessary.

Committee leaders did not take final votes during the hearing. Lawmakers asked presenters to submit written testimony and signaled they will continue drafting the bill with attention to the concerns raised about the 2026 funding gap, data utility and privacy, the scope and cost of additional regulatory duties, and the need for federal alignment on payment reforms.

The committee requested written testimony be posted to the committee web page before the next drafting steps and indicated it will reconcile overlapping planning efforts already underway (including Act 167 work) as it refines statutory language.