Vermont health care providers brace for an uncertain future

The Green Mountain Care Board anticipates greater detail from the federal government on what a so-called all-payer model could look like by the end of the month. Health care providers are scrambling to best position themselves for the changes such a system will bring.

This fall is widely expected to mark a transitional moment for health care reform in Vermont. Medical providers are bracing for the unknown and looking for safe harbor.

The health care-regulating Green Mountain Care Board anticipates the federal Centers for Medicare and Medicaid Services will outline the parameters of an all-payer model by the end of the month, according to Al Gobeille, the board’s chair.

An all-payer model would eventually be used to put the state’s health care providers on a fixed income, and allow the board to set payment rates for all of the payers. Payer is a health policy term that refers to entities that make payments for health services on behalf of individuals: Medicare, Medicaid and commercial insurers.

Such a model is diametrically opposed to how medical care has been compensated historically in the U.S., under the fee-for-service model. Fee-for-service medicine works by paying providers separate sums for each treatment, drug or office visit.