Vermont Medical Society flags administrative burden and watches AHEAD model

Jessa Barnard, executive director of the Vermont Medical Society, told the House Health Care Committee on Jan. 15, 2025, that Vermont clinicians reported completing an average of 21.4 prior authorizations per week and spending “a little over 15 hours a week on prior authorizations” before Act 111's provisions took effect.

Barnard summarized the society’s priorities: reducing administrative burden, stabilizing primary care payment, addressing workforce shortages and protecting patient access to preventive and mental health services. She said the society submitted comments to the Green Mountain Care Board and described its view of the proposed AHEAD model as “cautiously optimistic,” noting both potential federal dollars for primary care and risks for practices with patient mixes that would not benefit from specific AHEAD payments.

On administrative burden, Barnard presented baseline survey results collected under Act 111 and said the data are pre-Act 111; the society plans to repeat the survey in a year to measure the law’s effect. She urged expansion of Act 111’s prior-authorization protections to all primary care providers, a proposal carried in bill H.31 that the committee planned to review.

On workforce, Barnard said Vermont is short about 115 primary care physicians compared with benchmarks and urged extension or expansion of loan-repayment and residency programs, including a new family medicine residency being developed by federally qualified health centers.

Why it matters: Barnard argued that administrative work and low reimbursements contribute to clinician burnout, care delays and access problems. The society asked lawmakers to pursue policy changes that reduce prior-authorization burden, protect primary care funding during payment-model transitions and support workforce development.