Shumlin, a Democrat, said his administration views the federal healthcare law “as a bridge” that will allow the state to achieve cost containment in billing, electronic medical records and shifting the fee-for-service system to one that rewards outcomes.
“The federal bill gives us the ability to invest in the technology for our providers,” Shumlin said. “The federal bill is a partner to us in getting this done.”
Federal funding could be used to invest in infrastructure and technology that would ensure more efficient billing methods and a Green Mountain Care card that provides access to the resident's electronic health record, he said, adding that preventive care is another area in which the state can achieve savings.
In the meantime, the soon-to-be appointed five-member panel will hammer out the system's details, including financing. Two financing plans are slated to be sent to state House and Senate committees in 2013.
The Vermont Association of Hospitals and Health Systems and the Vermont Medical Society have remained neutral on the legislation, citing the details left unanswered.
Blue Cross and Blue Shield of Vermont, the state's largest insurer, has supported some portions of the law, including provisions related to payment reform and delivery-system reform, said Leigh Tofferi, director of government relations.
“The bill itself is short on specifics around the exchange and fewer specifics around the universal healthcare system, but it does call for a number of studies and analysis,” Tofferi said. “We're optimistic about the benefits that the health exchange can have for Vermonters. I say optimistic because the legislation doesn't lay out the specifics of how the health exchange will operate.”
State spending on healthcare in Vermont has doubled in the past decade, hitting $4.7 billion in 2009, and is expected to increase by $1.6 billion over the next four years, according to state data. Shumlin said reimbursement rates have led to the departure of rural doctors.
“We're losing our rural doctors, and our small rural hospitals are in jeopardy,” he said.
The same fears are a concern for the state's physicians, many of whom are facing retirement age at a time when Vermont is expected to have the second oldest population in the U.S. as well as a physician shortage in primary care and surgical specialties.
“If there's a high degree of uncertainty regarding the implementation of the legislation, will that cause physicians who are starting their careers to want to come to Vermont or will that uncertainly cause them to want to go to a place that isn't in the middle of major healthcare reform?” said Paul Harrington, executive vice president at the Vermont Medical Society.