Tuesday, June 23, 2026

NEED TO KNOW

Beth Roberts, President and CEO of Blue Cross and Blue Shield of VT, Estevan Garcia, MD, DrPH, MPA, FAAP, president and CEO of Southwestern Vermont Medical Center (SVMC), Randy Farmer, President and CEO of Vermont Information Technology Leaders (VITL), and Emily Mosites, MPH, PhD, Vermont State Epidemiologist, at the June VMS Board Retreat. 

Vermont Health Care Leaders Share Challenges, Opportunities with VMS 

New leaders in public health, hospitals, insurance, and Vermont’s health information exchange shared some of the challenges facing their organizations and answered questions from VMS Board members at the VMS Board Retreat held last week. Some highlights from their comments:

 💸 Beth Roberts, president of Blue Cross and Blue Shield of Vermont: 

• “We have to draw down hospital costs. […] We do not believe you can get there by using a hammer.” Roberts said she prefers the opportunity for BCBSVT to work with hospitals individually to negotiate reimbursement rates rather than having state regulators set rates at a certain percentage of Medicare.
• Radiology and labs are the most unaffordable hospital services in Vermont, according to Roberts. In most of New England, commercial insurers reimburses labs at 100% of Medicare. In Vermont, it’s double that rate. Likewise, radiology is typically reimbursed at 200% of Medicare elsewhere in the region. In Vermont, it’s as much as 1,500%. “We are out of whack,” Roberts said. She intends to focus on these service lines in hospital negotiations.
  
• BCBSVT is working to automate prior authorization responses using AI and will start testing models early next year. Their goal is to respond to prior authorization requests in five seconds or less.

🏥 Estevan Garcia, president of Southwestern Vermont Medical Center:

• The new head of SVMC is worried “about the amount of negative pressure that’s put on hospitals.”

• SVMC is looking to become a teaching hospital and create its own family medicine residency program. In part, that's due to recruitment issues. They currently have 17 primary care clinicians and staff have indicated they could benefit from 17 more.

• Garcia is looking to expand end-of-life and hospice care outside of the hospital. “We have quite a few patients who come in to die,” he said. “That’s [often] not the right place for them to be.”

🥼 Emily Mosites, epidemiologist with Vermont Department of Health:

• “Our team is 90% funded through the CDC. That is a vulnerability for us.”

• It's a busy time of year for epidemiologists: it's rabies season, tick season, and they're seeing a rise in Carbapenem-resistant organisms (bacteria resistant to most antibiotics)

🧑‍💻 Randy Farmer, CEO of VITL

• VITL is transitioning to a new platform that should improve the experience of clinicians who need data at their fingertips. They recently started working with the New England Collaborative Health Network.
• "I leave VITL open on my Desktop, all day, every day," one primary care clinician said at the meeting.

🗣️ Have GMCB Decisions Impacted Your Work?

VMS is gathering information about how Green Mountain Care Board budget decisions are impacting the health care workforce and clinical care. If you work for a hospital and have experienced changes in your practice due to budgetary pressures, we want to hear from you. Your input will help inform next steps by the VMS Board to represent the physician and PA voice. Reply to this email or send a message to Lexi at LKrupp@vtmd.org.

IN CASE YOU MISSED IT

💰💰💰 New Rural Health Transformation Grants Open

AHS has announced two new federal grant opportunities from the Rural Health Transformation program. The first focuses on shifting care outside of hospitals. Funding can be awarded to both hospital and non-hospital providers to "support the operational, staffing, and service delivery changes necessary to implement such a transition." This includes:

• 🫄 Regional prenatal, birthing, and postnatal care networks, including coordinated referral pathways and wraparound supports.

• 👶 Pediatric care redesign to improve access, care coordination, and integration.

• 🧠 Integrating mental health and co‑occurring substance use disorder services. 

• 🛌 Expanding or redesigning hospice and end‑of‑life care, including home‑based and community‑based options.

The second grant is for facility upgrades of $50,000 to $2 million in rural settings, including hospitals, primary and specialty care, home health and hospice agencies and others. These upgrades are meant to support service realignment, shared operations, and integrated care delivery and can include:

• 🛠️ Repairs, safety improvements, and electrical updates 
• 🦽 Accessibility enhancements
  
• 🩻 Improvements for specialized equipment or technology accommodations
• 👷 Reconfigured office or clinical areas

Read the full Notice of Funding Opportunity for the first grant and second grant and contact Amber Thomas at ahs.contracts@vermont.gov with questions. Applications for both grants close Friday, July 17.

⚕️Medicaid and ACA Changes Coming to Vermont

The Department of Vermont Health Access (DVHA) plans to send a postcard to every Medicaid enrollee in the state announcing eligibility changes coming next year, such as new work requirements for some beneficiaries. Additional letters will go out to Medicaid enrollees who will be subject to work requirements later this summer. “A lot of us are losing sleep over this stuff,” one longtime DVHA staffer said on a call earlier this week. 

ACA marketplace enrollees will likely have a shorter enrollment period this year, from Nov. 1 to Dec. 15, and face new income verification requirements. Depending on legal cases, the state could have some flexibility in how they roll out these changes. 

Vermont is also beginning a “revalidation of high-risk Medicaid providers” at the request of the U.S. Department of Health and Human Services. This includes nursing facilities, home health agencies, hospice providers, durable medical equipment/prosthetic, orthotic, supplies (DMEPOS) vendors, and providers of any type designated as High Risk due to credible allegations of fraud, waste, or abuse in the Medicaid program. For more information on the state's plan, click here.

EVENTS

Perinatal OCD Training

Wednesday, July 1, 12 - 4 p.m. | Remote

Perinatal mental health clinicians often face complex decisions when OCD symptoms overlap with other perinatal conditions. This training will exploring screening and treatment considerations specific to working with perinatal OCD and demonstrate how to apply Exposure and Response Prevention (ERP) within a holistic, trauma-informed framework.

Vermont Extreme Weather People's Hearing

Wednesday, July 8, 6 - 8 p.m. | Barre, VT

The Climate Action Campaign is organizing an event for Vermonters to share their experiences with extreme weather from flooding to heat, wildfire smoke, tick-borne illness and more. A VMS member is slated to speak about skin infections among patients following exposure to floodwaters. 

If you're interested in speaking, you can fill out this form or contact Aaron Petykowski. 

UVM Menopause Conference

Friday, Sept. 11, 7:30 a.m. - 4:30 p.m. | South Burlington

Join the Menopause Clinical Update, a comprehensive, evidence-based educational program designed for clinicians seeking to enhance their expertise in menopause care. This full-day session will explore the critical role of estrogen across the lifespan, with practical guidance on managing perimenopause, optimizing menopausal hormone therapy (MHT) prescribing, and addressing key long-term health considerations.

See the full agenda here.

AMA Independent Practice Accelerator Workshop  

Sept. 11–12 | Chicago, IL 

Thinking about starting or growing an independent practice? Get the essential knowledge, practical skills and confidence you need to launch a new practice or strengthen the one you already have! The AMA Independent Practice Accelerator Workshop is a two-day, in-person event designed exclusively for physicians.

Register today.

AMPAC Campaign School 

Sept. 11–13 | Washington, DC

If you're interested in becoming more involved in politics – whether you're attracted to grassroots efforts or considering becoming a candidate for public office – you can join this training on how to run an effective campaign.

When Physicians Become Patients: Providing Care for General Medical, Mental Health, and Substance Use Disorders

Wednesday, Sept. 23, 1 - 3pm ET | Remote

It happens more often than you think — a colleague, a fellow resident, or attending walks into your exam room as a patient. The clinical knowledge gap disappears, but everything else gets complicated fast. Power dynamics shift. Trust becomes fragile. Boundaries blur. And most physicians say they weren't prepared for any of it. 

The webinar is eligible for 2 hours of CME credit

Save the Date: Vermont ACP Annual Scientific Meeting

Friday, Oct. 9 | Stowe, VT

This will be an in-person meeting at the Trapp Family Lodge with no virtual option. We will host a poster competition for resident and student members.

2026 Collaborative Meeting

Nov. 13 - 14 | Stowe, VT

The 2026 Collaborative Meeting is taking place at Topnotch Resort in Stowe. Please save the date and join us this fall.

More information here.

For more information about offerings from UVM Continuing Medical and Interprofessional Education, visit here.

Vermont Medical Society

PO Box 153

Williamstown, VT 05679

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