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Vermont Health First urges CON reform and sustainable reimbursement to shore up independent practices
Summary
Susan Ritzen of Vermont Health First told the Senate committee that independent practices deliver high‑quality, lower‑cost care, warned that ending current all‑payer funding arrangements will strain practices, and supported certificate‑of‑need reform and Act 111 administrative changes.
Susan Ritzen, executive director of Vermont Health First, told the Senate Health and Welfare Committee on Jan. 22 that independent, physician‑led practices supply high‑quality primary and specialty care across the state and need policy and payment support to remain viable.
Ritzen said Vermont Health First represents 62 primary care and specialty practices across 11 counties and more than 215 clinicians, including about 124 primary care clinicians serving roughly 88,000 patients. She described independent practices as "physician‑led, patient‑centered" options that increase system resiliency and give patients choices beyond large health systems.
Policy priorities Ritzen raised - Certificate of Need (CON) reform: Ritzen said Vermont Health First supports changes to CON that would level the playing field between hospital and nonhospital providers. She said the association shared draft legislation with committee leadership that would raise CON thresholds to $10,000,000 across the board; the proposal is intended to reduce barriers to entry for nonhospital providers.
- Funding and reimbursement: Ritzen said many Blueprint and other primary care practices participate in all‑payer arrangements that will conclude at the end of 2025 and that practices will lose that funding at that time. She urged lawmakers to consider sustainable reimbursement policies that keep pace with costs and help practices recruit clinicians and staff.
- Administrative burden: Ritzen said Act 111 from the prior session began to standardize and reduce insurer administrative burdens around prior authorization, claims edits and step therapy, but that ongoing shifts such as growth in Medicare Advantage plans maintain high administrative costs for practices.
Why it matters: Ritzen argued that independent practices provide accessible, lower‑cost care and that regulatory and payment changes that favor hospital systems can reduce access and raise costs. She pointed to the Green Mountain Surgery Center as a nonhospital example that expanded options for patients and noted the center's recognition in national rankings.
Ending: Ritzen offered to provide more details and to testify on specific CON bills; senators thanked her and said they would follow up. No formal committee action or vote was taken during the testimony.
Selected quote: "The value of independent practices is quite high. You get a lot for your money," Ritzen said.
