Advocates tell Vermont Health Care Committee to set concrete hospital-price goals and fix reporting gaps

Advocates for patients and the Health Care Advocate’s office told the Vermont House Health Care Committee that clearer goals and better data are needed to rein in hospital prices and protect patients from medical debt.

Mike Fisher of Vermont Legal Aid and an HCA representative told the committee that the office receives confidential filings and participates in Green Mountain Care Board budget reviews, and that its priorities include data integrity, expanding patient financial assistance, and shifting regulation away from a single net-patient-revenue focus.

"We care a lot about data and data being high quality and transparent and standardized," the HCA representative said, arguing the board needs consistent reporting across hospitals so regulators can compare like with like.

Why it matters: Committee members pressed witnesses about unexplained variances between what some hospitals report to federal authorities versus what they report to the board — a discrepancy HCA officials said can affect whether a patient’s unpaid bill is treated as charity care (hospital-assistance) or as bad debt (a collection against the patient). HCA witnesses said that distinction matters for patients’ financial outcomes.

HCA also proposed clearer, systemwide price targets. The office said it favors placing Vermont hospitals around the sixth national decile for prices — not near the ninth decile where some hospitals currently sit — and urged the committee to define both where the state should aim and how quickly.

Committee members and witnesses discussed several possible levers, including tighter reporting standards, clearer board guidance and more prescriptive timelines for price reductions. Witnesses flagged the need to study patient flows and ownership patterns after several hospitals joined out-of-state networks, and asked staff to share analyses such as RAND’s comparative payment data and a congressional budget office review of cost-reduction tools.

The session closed with committee members asking the HCA and staff to provide follow-up materials, including an impact report on prior debt-reduction legislation and any available patient-flow analyses that might clarify out‑of‑state network effects.

What’s next: The committee asked for additional reports and indicated it would return to hospital budget issues in subsequent hearings; no formal vote or bill action on hospital-price policy occurred at this meeting.