Issue Position: 25 Ways to Bend Vermont Health Care Cost Curve

Issue Position

Adopt common sense reforms to attack high costs

All over America, our best minds are focused on reducing health care cost. This work has identified numerous evidence-based solutions, some of which we could begin using today. We can begin planning to pilot or test others. Many have been successfully implemented and are in use in other states. Not all of these may work in Vermont, but isn't it time we try?

Make wellness pay off: Allow discounts for healthy lifestyles

Lower the cost of individual health insurance by making it Vermont income tax deductible

Post prices: patients should know what treatment costs

Collect and post consumers' ratings of insurance carriers to encourage better performance

Create price transparency in provider fees and pharmaceutical costs. Create a centralized web site where patients can comparison shop for medications and elective medical and surgical services

Pave the way for interstate insurance purchases by opening dialog with bordering states

Aggressively root out fraud, waste, error and abuse, something Vermont has never done

Health Savings Accounts: Encourage use of high deductible consumer-directed health plans coupled with focused consumer education and waived deductibles for preventive treatments

Reduce emergency room visits by creating extended-day walk-in clinics within one hour of every Vermonter

Perform independent performance audits to examine every cost and the health-effectiveness of every mandate

Allow health care insurance to be purchased outside the Exchanges

Pilot point-of-service reimbursement. Qualify and sign-up the uninsured for programs at any health care facility

Begin a dialog with commercial insurers to identify barriers to their re-entry into the Vermont marketplace in order to increase choice and competition

Establish reasonable insurance company performance standards, including timeliness of claims processing and provider payments; publically post results

Implement malpractice reforms, such as requiring arbitration, capping non-economic damages and providing safe harbors for providers who practice evidence-based medicine.

Reform how we pay for care to encourage providers to choose lower cost solutions; encourage and compensate for telephone consultations and other lower cost alternatives.

Make Vermont a medical tourism destination. A niche business opportunity to marry tourism and health care: grow capacity while reducing cost. We have four million potential users just across our northern border

Stop paying for duplicate diagnostic testing when patients are moved to a tertiary care hospital. If we can't rely on community hospitals' tests, they shouldn't be conducting tests

Expand training for and use of Nurse Practitioners and Physician's Assistants to lower cost and to extend the range of provider coverage. Use technology to ensure remote outreach

Explore the alternative of purchasing or contracting for a pre-written or commercial health care exchange in lieu of spending hundreds of millions to create one of our own

Create "captive" insurance plans in which businesses join together to create multi-employer health insurance

Educate the public about their doctor's responsibility to avoid unnecessary tests or treatments; establish physician "safe harbors"

Reduce Medicaid payments to out-of-state providers, since they are not part of the provider tax process

Focus on universal health care, not healthcare for the universe: Review who we cover and how to limit Vermont's health care plans to Vermonters

Encourage doctors to stop performing 45 frequently unnecessary and costly procedures as suggested by nine prominent physician groups, including the American Academy of Family Physicians, the American College of Radiology and the American Academy of Cardiology

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