February 11, 2025

NEED TO KNOW

VMS Visits Washington

This week, VMS President, Katie Marvin, MD, and VMS Executive Director, Jessa Barnard, are in Washington, DC to meet with Vermont’s Congressional Delegation.  They head today to talk with the offices of Senator Bernie Sanders, Senator Peter Welch and Representative Becca Balint.  On the agenda are asking for support to end the year over year cuts to the Medicare professional fee schedule, as well as discussing efforts to protect our national and state public health infrastructure, research funding, health care coverage and health care workforce from the onslaught of executive orders and threats of Congressional funding cuts. 

Action Alert - 2026 Primary Care Funding Gap – Contact Lawmakers about Loss of OCVT, Blueprint & DULCE Funds

As many VMS members know, due to the winddown of OneCare Vermont at the end of 2025 and decision to not start the AHEAD Model before 2027, there will be a significant gap in funding available for primary care services and supports in calendar year 2026.  VMS is planning for and advocating for ways of filling this gap in funding. 

Please join VMS in asking the legislature to address gaps left by not joining AHEAD until 2027 by including in the SFY2026 budget one-time funding of $5.5 million for primary care programs and $4.5 million in state funds to continue Medicare-funded Blueprint for Health programs.   In addition, the Governor’s proposed state budget currently does not include funding for the Blueprint’s 2 year expansion of embedded mental health supports.  Please explain how devastating any loss of funds for primary care services will be at this time.

Please contact the House Health Care Committee and House Appropriations Committee:

ablack@leg.state.vt.us; fmcfaun@leg.state.vt.us; dberbeco@leg.state.vt.us; bcina@leg.state.vt.us; mcordes@leg.state.vt.us; wcritchlow@leg.state.vt.us; ademar@leg.state.vt.us; lgoldman@leg.state.vt.us; lhoughton@leg.state.vt.us; wpage@leg.state.vt.us; dpowers@leg.state.vt.us; kvarin@leg.state.vt.us; rscheu@leg.state.vt.us; jharrison@leg.state.vt.us; tbluemle@leg.state.vt.us; edickinson@leg.state.vt.us; jkascenska@leg.state.vt.us; wlaroche@leg.state.vt.us; mmrowicki@leg.state.vt.us;
mnigro@leg.state.vt.us; tsquirrell@leg.state.vt.us; tstevens@leg.state.vt.us; dyacovone@leg.state.vt.us; epedley@leg.state.vt.us;

In more detail the loss of funding for the State Fiscal Year July 2025-June 2026 includes:

Payments to primary care would stabilize in 2027, when joining the AHEAD Model means that Medicare will restart their payments to the Blueprint PCMH and CHT programs and begin making $17 per Medicare beneficiary-per month payments to participating primary care practices.   

See VMS’ handout for lawmakers here and contact Jessa Barnard at jbarnard@vtmd.org for more information.  Thank you for your support for these crucial programs – VMS knows how central they are to your practices and patients!

Lawmakers Want Answers on Health Care Affordability

Last week, the House Health Care and Senate Health and Welfare Committees continued to seek information and rapid solutions to Vermont's health care affordability problem.  Testimony from the Green Mountain Care Board and Millbank Fund pointed to commercial hospital rates as the most significant cost driver to the health care system and are looking for savings. Lawmakers have begun to weigh significant system changes like global hospital budgets, reference-based pricing for plans that cover Vermont teachers and State Employees, and increased oversight of hospital budgets. One area where there seems to be general agreement is raising the threshold for needing to go through the Certificate of Need process, and VMS testified in favor of changes in the House Health Care Committee. 

The House has also been focusing on the SFY25 Budget Adjustment.  A budget adjustment proposal has passed the House, is now heading to the Senate and includes:

• $835,073 for the Bridges to Health Program;  
• $500,000 for community grants related to health equity;
• Extends the 2-yr Blueprint for Health mental health and substance use pilot program to 3-yrs, allowing still undetermined unexpended funds to be carried over;
• $10 million in Medicaid Provider Stabilization Funds, with $4 million dedicated to mental health and substance use providers; 
• $791,667 is appropriated in SFY25 to cover a 3.5% Medicare Economic Index (MEI) adjustment for Federally Qualified Health Centers (FQHCs); and
• $2.1 million in state funds/$5.2 total funds for for ACO reconciliation.

This week the Senate Health and Welfare Committee is scheduled to work on a Committee bill that could include health reform policies aimed at cutting costs and will also hear from Jessa Barnard on S.28, a law aimed at closing gaps in Vermont “shield law” that protects health care clinicians providing reproductive and gender affirming care services.   A bill to license freestanding birth centers is also up for testimony. 

Physicians Thank Commissioner Mark Levine, MD, for Service

Last week, Governor Phil Scott announced Commissioner of Health Mark A. Levine MD will be retiring at the end of March 2025.

“Dr Levine has been a tremendous asset, to not only me, but the entire State of Vermont. I know this decision weighed heavily on him, as he deeply loves helping others, which was apparent throughout his career in medicine as well as his last eight years in public service,” said Governor Phil Scott in his statement announcing Dr. Levine’s retirement. “I will be forever grateful for his advice and counsel over the years, but especially during the pandemic, as he appeared with me daily at press conferences during those difficult days, giving much comfort to Vermonters as our very own ‘Country Doc.’”

Dr. Levine, 71, of Shelburne was first appointed by Governor Scott in 2017 and is currently one of the Administration’s longest-tenured commissioners. He led his department through the COVID-19 pandemic and has served as a key advisor on public health matters.

Vermont physicians reacted with gratitude and sadness to hear that Dr. Levine is retiring from the Commissioner role. 

“According to Katie Marvin, MD, president of the Vermont Medical Society, “Dr. Mark Levine has been an outstanding commissioner of health, with so many notable contributions to the health and safety of ALL Vermonters. This is especially noticeable to those of us in rural primary care, as he supports our day-to-day efforts, and empowers our front line health care workforce. He bolstered the Hub and Spoke program, allowing us to provide life-saving, evidenced based care for patients with opiate use disorder in all corners of the state, resulting in zero wait times for treatment, wider access to opiate agonist medications and reduced stigma around treating substance use disorder. Dr. Levine has supported critical programs to protect our most vulnerable patients:  children, elderly, LGBTQ+, new Americans, and so many struggling with financial hardship and other social determinants of health. During Covid, Dr. Levine was reachable at all hours, even texting with this family doc about what to advise her local schools and clinics on quickly changing policy. His oversight has helped Vermont remain one healthiest states in the Nation. Congratulations on your retirement, Dr Levine. We thank you for your service.”

Breena Holmes, MD, president of the Vermont Chapter of the American Academy of Pediatrics also thanked Dr. Levine: “Dr. Levine led our state through a global pandemic with science, teamwork and grace.  He was remarkably accessible to medical professionals and public health teams through the entire journey- always picking up the phone, showing up a town halls and other meetings with an openness, even when the answers were not clear.  I will miss his passion for public health, his capacity to become expert in a topic in record time and his true vision for a healthier Vermont.  He is a model for public health leadership and we wish him well in whatever her decides to do next!”

Under Commissioner Levine's leadership, the Department focused on critical public health initiatives including: protecting children's health through nurse home visiting programs for newborn children, lead exposure reduction, and prevention of adolescent drug, alcohol and tobacco use and vaping; opioid overdose and suicide deaths; health equity; and better emergency preparedness for infectious diseases, natural disasters, and potential biological threats.

Next Commissioner Call - Thursday, March 6, 2025

The Commissioner of Health, Mark Levine, MD, will hold his final Public Health Update with VMS Members Thursday, March 6th at 12:30 pm. Please join us to hear updates and recognize the Commissioner for his dedicated service to public health in Vermont.  You can join the zoom meetings here.

He held his most recent VMS member call on February 6th. Notes from the call are here. The discussion focused on updates on the "Quad-demic" as well as the effect of the current National climate on Vermont.  The Commissioner was clear that Vermont will continue to work to protect public health stating, "We won’t compromise what we do and jeopardize the fabric of what is right."

As stated above, the Commissioner will be ending his service as the Health Commissioner.  If you are interested in learning more about this position click here.

Webinar Materials on Immigration Enforcement; Federal Executive Order Resources

Last Thursday, Treasurer Mike Pieciak’s Task Force on the Federal Transition, the Vermont Chamber of Commerce, and Vermont Businesses for Social Responsibility (VBSR) hosted a webinar for Vermont employers to discuss their rights, obligations, and prudent steps they can take to prepare for a worksite visit from Immigration & Customs Enforcement (ICE).   VMS was made aware that registration reached capacity for this event!  A recording of the webinar will be posted via the Office of the State Treasurer YouTube Channel.  Individuals also be added to a distribution list and receive a recording of the webinar by emailing: treasurers.office@vermont.gov.

For more resources to assist you and your patients with immigration enforcement, see the VMS website here.   Also see VMS’ special report tracking the latest information on recent Executive Orders impacting health care.

The PA Association of Vermont 42nd Annual Winter CME Conference
Held at the Stoweflake Resort on January 30^th.  Pictured left to right are:  VMS Immediate Past President Becca Bell, MD; VMS President, Katie Marvin, MD;  VMS Board PA representative and PAAV President, Lee Morissette, DMSc, PA-C, DFAAPA; and VMS Board PA representative and PAAV Immediate Past President, Sarah Bushweller, PA-C. 

MISC.

Act 111/Department Financial Regulation Guidance- Lunch and Learn – April 4

On April 4^th from 12-1pm join the Director of Health Insurance Regulation at the Department of Financial Regulation, Sebastian Arduengo, for a walk through of the Act 111 DFR Guidance.  This guidance provides details for payers and practices regarding how to implement Act 111’s changes to prior authorization and other insurance practices.

View the guidance here.

Join the meeting:

Microsoft Teams - Join the meeting now
Meeting ID: 223 678 480 489 / Passcode: mA73fm7y

Dial in by phone - +1 802-828-7667,,963404137# 

As Practices Fight to Survive, MA Health Plans See Another Payday

Congress wrapped up its business in 2024 by failing to stop a fifth consecutive year of physician pay cuts that are threatening access to high-quality care, but Medicare Advantage (MA) plans learned from the Centers for Medicare & Medicaid Services that they are in line to get an average pay boost of 4.33% from 2025 to 2026.

Physicians, by contrast, are seeing 2.8% across-the-board cuts due to a broken and unsustainable Medicare payment system that especially affects patients with disabilities and those who live in rural areas. The congressional failure in late 2024 came despite AMA’s leading the charge to reform the Medicare payment system to avoid what AMA President Bruce A. Scott, MD, has called an “oncoming crisis” in medical care. 

Hundreds of physicians from across the country, including VMS President Katie Marvin, MD, are expected to come out in force this week for the AMA National Advocacy Conference in Washington, D.C., Feb. 10–12. The goal is to show Congress the real-life impact of the broken Medicare payment system on patients and on physician practices and the communities across America that doctors serve.  Read more from the AMA here. 

VMS Board Meeting Updates

The VMS Board met last Wednesday, February 5^th.  The Board considered new membership and elected the following new Board members:

• Norman Ward, MD, to an At-Large seat
• Lydia Grondin, MD, representing anesthesia
• Katelin Morrissette, MD, representing critical care/transport
• Ayushya Ajmani, a Geisel first year medical student, to a medical student seat
• Nikolas Hernandez, a Geisel first year medical student, to a medical student seat

The Board also thanked the following Board members who rotated off of the Board for their service: Jacob Martin, MD (representing anesthesia); Ed Borrazzo, MD (representing surgery); Amy Gregory, MD (representing ophthalmology).  

The Board had lengthy discussions around the impact of and response to federal executive orders impacting health care and health care bills pending in the Vermont legislature. 

New Resolve Podcast – Get the Most Out of Your Health Care Career

Resolve contract review service launched a podcast at the end of December, The Review! The Review Podcast features the Resolve legal team and other guests discussing physician employment contract terms, compensation data, and other topics surrounding physician careers.  Learn more about Resolve and discounted legal review services available through VMS here.

New England History of Medicine Society Black History Month Presentation: William Augustus Hinton, MD

Join the New England History of Medicine Society's Black History Month presentation on William Augustus Hinton, MD on February 25th at 7pm via Zoom. 

William Augustus Hinton, MD was born to enslaved parents and he rose to be the first African American professor at Harvard. 

The presentation will be led by Al DeMaria, MD who is the retired Medical Director of Infectious Diseases at the Hinton Lab of the Mass DPH. 

Register for the free event here. 

Salary Data and Contract Review Tips: March 18th, 12-1pm

VMS has partnered with Resolve to help connect members to contract review services and access to compensation data. On March 18th from 12-1pm join Resolve CEO Kyle Claussen for a webinar to learn tips about physician employment contracts. Register here. How do you know what you are worth? What's in a normal contract? How do you know if you have leverage? Kyle will address key contract provisions including:

1. Compensation
2. Call Coverage
3. Maternity Leave
4. Non-competes
5. Side Gigs
6. Intellectual Property
7. Private Equity Buy-outs

Bring your questions! Whether you are considering your first job after residency, thinking about a position change or just want to understand what is in your current contract, this webinar is for you.

Kyle Claussen is the CEO of Resolve, an attorney and physician compensation and contract expert. He has spent the last decade advocating for physicians in their employment contracts. Kyle is married to an ophthalmologist, has 3 kids, and a dog.

Register for the webinar here.

Back for 2025, Quarterly Financial Webinars Hosted by Pinnacle Wealth (FKA Pastore Financial Group)

Pinnacle Wealth has been a supporter of VMS for decades.  Our independent, fiduciary advisors will share insights to help you on your financial journey.  Can’t make the webinar but have quesitons? Please email info@pinnaclevt.com for an individual meeting.

Early Career: Questioning your student loan strategy?  Do you have the right amount of life and disability insurance?  Are you maximizing opportunities to accumulate wealth and minimize taxes? Join us for an exclusive seminar for VMS members. We will discuss updates to SAVE and PSLF, important insurance concepts, and strategies to maximize accumulation during your early years as a physician.

Register for Tuesday evening, February 11^th from 7-8pm 

Approaching Retirement: Are you confident in your retirement plan? Concerned about market volatility? Do you have a strategy to protect your investments while maximizing returns? Join us for an exclusive retirement planning seminar for VMS members.  We will discuss key strategies to secure your financial future and enhance your investment growth in today’s unpredictable market.

Register for Wednesday evening, February 12^th from 7-8pm 

EVENTS

Learning Collaboratives on In-Basket Reduction and Reducing Regulatory Burden

October 2024 – March 2025

AMA STEPS Forward^® Innovation Academy is launching two new, six-month learning collaboratives on optimizing the in-basket to reduce work burden and rethinking how organizations apply regulatory rules to clinical practice. Each collaborative will convene dyads or triads of leadership representatives from multiple organizations to engage in a longitudinal shared learning experience. Limited space available. Learn more.

For more information about offerings from UVM CMIE, visit here.

Vermont Medical Society

134 Main Street

Montpelier, VT 05602

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