Health Reforms Underway in Vermont

By Ross Sneyd | July 5, 2006

Health care reform quietly began in Vermont over the weekend although it’ll be a while before it makes a difference at a doctor’s office or a hospital emergency room.

With Saturday’s start of the state’s new budget year, taxes for cigarettes, cigars, chewing and pipe tobacco rose.

The money that begins flowing into the state treasury largely is going into the bank, where it will stay until it’s needed in about 16 months when Vermonters who don’t have health insurance can begin getting it with the state’s help.

Before the Catamount Health insurance plan can be offered — and subsidized by the state — money needs to be on hand to pay for it and a lot of technical work needs to be done to prepare for it.

Even though it will be October 2007 before people can take advantage of Catamount Health, a lot of work already is under way, said Susan Besio, recently appointed to head up the reform effort.

“A lot of these things that are starting July first authorize departments to do certain things,” Besio said.

The Health Department, for example, was authorized to begin Saturday drafting new rules for how advance directives can be drawn up. Those are the documents people can sign that direct how they want to receive medical care if they’re unable to make such decisions themselves.

The Health Department also will begin looking into creating grants and stipends to persuade health care providers to participate in an initiative to deliver care more effectively to people suffering from such chronic conditions as diabetes and heart ailments.

And a work group is forming that will develop a common insurance claims form system so all companies use the same information when sending out bills for care.

“As you can well imagine, people are working very, very hard to meet the other deadlines that are coming very shortly and figuring out the implementation details to create Catamount and the employer-sponsored initiative,” Besio said.

But some consumers are eager to move the process faster if they can. The Department of Banking, Insurance, Securities and Health Care Administration as well as the governor’s hotline have each received a handful of telephone calls about enrolling in Catamount Health.

“All we can say at this point is it doesn’t really go into effect until a year from now,” Besio said.

Advocates of the initiative believe that it will help to drive down health care costs even as it extends coverage to an estimated 96 percent of the population within five years. But getting to that point is requiring state government, insurance companies, health care providers and business groups to prepare well in advance.

Besio and other state workers have begun meeting with those various interest groups to prepare for what promises to be big changes in the system. Besio, a former state mental health commissioner, said she was looking forward to the challenge.

“There are multiple things in this legislation that I think are going to help us bring down the cost of health care,” she said. “There are multiple pieces to help us begin to bring down the cost shift. There are things that are going to improve quality. There are ways to give people access who are currently uninsured. All the different pieces fit.”

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