House passes S.197 after committee amendments to pursue universal primary care payment reform

The House on Wednesday passed S.197, an act to advance payment reform for primary care, after the Health Care Committee reported a strike-all amendment and related committees recommended concurrence.

Representative Goldman, speaking for the Health Care Committee, said the bill is intended to invest in primary care and to design a payment model that shifts away from fee-for-service by providing practices with per-member-per-month payments. The committee cited evidence that primary care is underfunded (the presenter noted that in 2020 only 10.2% of medical spending went to primary care) and that Vermont faces clinician shortages. The legislative plan includes multiple reports and timelines: the Blueprint director must report by Jan. 15, 2027 on payment changes and an operational plan; AHS and the Green Mountain Care Board must report baseline per-person-per-month spending by payer by Jan. 15, 2027; AHS must propose targets and a schedule for increasing primary care spending by Jan. 1, 2028; and several agencies must assess the appropriate distribution of responsibilities for health care reform by Jan. 15, 2027.

Committees (Health Care 10-0-1; Ways and Means 9-1-1; Appropriations 11-0-0) reviewed testimony from a broad set of stakeholders, including the Vermont Medical Society, Green Mountain Care Board, community health centers, academic experts, and insurers. After committee reports and floor amendments were adopted, the House ordered third reading and passed S.197 in concurrence with the proposal of amendment; the action was messaged to the Senate.