Hospitals tell Health Care Committee AHEAD model and rapid price cuts risk rural services

Devon Green, vice president at the Vermont Association of Hospitals and Health Systems, told the Health Care Committee that Vermont hospitals support transformation but warned that the AHEAD federal model offered to replace the state—s all-payer approach leaves little room for states to design different payment structures.

Green said the state—s hospitals provide uniquely required services — including 24/7 emergency departments governed by the federal Emergency Medical Treatment and Labor Act (EMTALA) — and serve as critical partners in emergency management, supply-chain contingency planning and disaster response.

The association official told lawmakers that critical access hospitals, which federal rules limit to 25 beds and an average length of stay of no more than 96 hours, rely on cost-based Medicare reimbursement. "Critical access hospitals were designated specifically by the federal government to improve access to health care in rural communities," Green said. She noted Vermont has eight critical access hospitals and one Medicare-dependent hospital, Brattleboro Memorial Hospital.

Green cited state data posted by the Green Mountain Care Board showing Medicare…