February 18, 2025

NEED TO KNOW

Reflections on DC from VMS President, Katie Marvin, MD

Jessa and I had the opportunity to attend the 2025 AMA National Advocacy Conference in Washington DC last week, and we brought Vermont, and snow, to the Capitol!   The topic of focus was Medicare rates, but we heard from our Vermont senators on urgency around Medicaid as well.   Unlike many of the other state medical reps, we generally agree with our legislators’ positions on bills.   So, we also had a chance to talk about other pertinent subjects - like the unknowns of the AHEAD Model, building our workforce pipeline and the current firehose of threatening executive orders on research funding, CDC resource pages, LGBTQ+ health services, among others.  There is no shortage of topics, and many are concerning, especially to a medical system already in peril.  

The AMA has received criticism for not responding with a stronger voice to some of these topics.   With so many Executive Orders, speakers explained that they cannot attack all of these issues at once.   They want to be “thoughtful” and not over respond to this early “shock and awe” phase of the new administration.   Instead, the president-elect Bobby Mukkamala, MD, an ENT from Flint, Michigan, said, his goal is to be strategic, and intentional, and to outlast the hype.  I really liked what he had to say about taking care of people in his underserved community, where the life expectancy is 20 years less than in a neighboring wealthier neighborhood.   I was uplifted that this physician who will lead the AMA in organized medicine was so in touch with worsening social determinants of health.

During our legislative meetings we talked with the staffers of Senators Sanders and Welch, and with Becca Balint herself.   They were interested in hearing about local Vermont concerns, but also brought their top issues to us.   They asked for patient stories regarding Medicaid, especially stories as they pertain to children or substance use disorder care, asap.  I asked that they try to make the language and acronyms more understandable to normal people.   Health care policy is unnecessarily complicated, and honestly hard to follow.    So, we trust them to understand the politics of Washington, and use our stories to meet these common goals.  Thank you for those who already sent stories to Stephanie at VMS at swinters@vtmd.org.  If you have more, you can keep sending them. 

Even with all the confusing talk, the feeling of destabilization, and the unknowns of Washington right now, I have to say these events and meetings provide hope.   Surrounded by (mostly) like-minded physicians and being heard by legislative teams who want great patient care, AND for us to be happy in our professions, it is encouraging to know that we are not alone in our worries. It was also a reminder to speak up.  The keynote speaker, Michael Sorrell, the president of Paul Quinn College told an inspirational story of his path to rebuilding his school from near closure, to thriving.   He told this group of seasoned physicians to BE BOLD.  To turn around a failing institution, he said, you must raise your voices, you must stand up, and you must lead from wherever you are.   Basically, let’s not wait any longer to demand change.   And my ask is that we all work on this together with a common mission:  do what is evidenced based in the best interest of patient care.   Stick to those basic tenants we have used to guide our practices each day of our careers.  

To read my full comments, click here.  And, thank you for trusting us to represent you in Washington.   Please reach out with any questions or thoughts to president@vtmd.org.

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 focusing our advocacy efforts this week on the problem – including organizing a press conference for Thursday morning. 

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!

Health Committees Take Up Freestanding Birth Center Bills, CON Flexibility and Shield Law

Last week, both the House Health Care and Senate Health and Welfare Committees took up bills aimed at developing a licensure structure for freestanding birth centers, H.40 and S.18. Lauren Macafee, M.D., OB/GYN, spoke on behalf of the Vermont Medical Society and the American College of Obstetricians and Gynecologists (ACOG) to offer her perspective on the value of delivering in the safest environment as possible and the challenges facing hospital labor & delivery units in Vermont as our State has the lowest number of annual births per year. These bills would also exempt free-standing birth centers from the certificate of need (CON) process. Another bill advancing in House Health Care, H.96, would increase the financial thresholds that trigger CONs. Jessa Barnard, Executive Director of the Vermont Medical Society, testified on S.28, a bill aimed at shielding reproductive health care providers from political retribution and protecting patient access to reproductive and gender affirming health care services. Click here for her testimony. Jessa and the VMS Policy team are working with the Office of Professional Regulation and the Board of Medical Practice on a new draft of this bill, which we expect this week. H.31, the prior authorization and claims edit clarification bill, passed the Senate Health and Welfare Committee by a vote of 5-0 and will be taken up on the Senate floor tomorrow. 

This week, the Health Committees are both continuing their discussions on health reform. The House Health Care Committee is starting their week with a hearing on reference-based pricing experience in Oregon and Montana. The Senate Health and Welfare Committee is working on developing a Committee bill based on these recommendations. 

MISC.

Planning for Retirement: March 11th, 5pm EST

VMS has partnered with Planwell to present the Planning for Retirement webinar.

Retirement is often the first thing we think about when we talk about our overall financial well-being. In this seminar, you will learn the basics of retirement planning and what strategies you can use to secure your plan. This presentation covers how to envision your retirement, build your retirement strategy, different sources of retirement income, building your nest egg, and key risks to consider.

View the event flyer here. 

Register here.

Vermont Retirement Systems Seek Member for Medical Review Board

Vermont’s three public retirement systems seek a licensed physician to be a member of the State’s Medical Review Board (MRB).  The MRB is a State Board comprised of three physicians that reviews and makes recommendations on applications for disability retirement benefits.  The Board is staffed by employees of the Retirement Division, which is housed in the State Treasurer’s Office. The position involves a limited commitment of approximately 6 hours/month.  For more information about the position, please see here. Interested candidates should send a resume and statement of interest to Briana.Howard@vermont.gov.

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.

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.

EVENTS

Learning Collaboratives on In-Basket Reduction and Reducing Regulatory Burden

February 2025 – 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.

Navigating Workplace Violence: A Webinar Series on De-escalation Strategies for Healthcare Professionals

February 20, and March 20, 2025

February 20th 1:00 PM to 2:00 PM - "Safety Strategies for Managing Agitation and Aggression"

Led by Brendan Riley, an expert in healthcare security and violence prevention, he will share practical tools and insights to create a safer workplace. For individuals working within the healthcare industry who are engaging in interactions with individuals who present challenging behaviors, this webinar is tailored to support your needs.

March 20th, 1:00 PM to 2:00 PM - "Workplace Violence Prevention: Focusing on What’s Most Important"

This session is led by Brendan Riley and is designed to provide professionals with advanced strategies to effectively address workplace risks and foster a safe, supportive environment. This webinar is crafted to address the challenges faced by all healthcare workers, offering insights that can benefit professionals across the entire spectrum of care.

Register here for either webinar.

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

Vermont Medical Society

134 Main Street

Montpelier, VT 05602

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