Action continues in the committee rooms with little time spent on the House floor. The Governor’s veto of the paid family leave bill was sustained on a vote of 99-51. In order to override a veto each chamber needs a two-thirds majority vote.

The Health Care Committee continues to focus on workforce, affordability and accessibility. All three being intimately linked together. We are experiencing shortages in all professions from unlicensed personal care attendants and direct support professionals, to physicians — across all care units. The situation in Vermont is not unique, these same issues are happening across the country. In Vermont, the workforce crisis is driven by several factors: tight national and local labor markets, aging workforce, provider burnout, rising higher education costs, limited educational capacity, insufficient Medicaid rates and broader economic development challenges. The health care committee is taking testimony on how we license medical professionals, what background educators need, programs for student loan repayment and an expansion of telehealth, just to name a few focus areas, in an effort to turn the tide.

I attended a meeting where Dr. Joshua Sharfstein provided a national perspective on Vermont’s health reform. He spoke of the widening gap between U.S. health spending and that of other countries and the decline in U.S. life expectancy. He discussed the limits of fee for service reimbursement, the current U.S. model, and how that model incentivizes expensive procedures, creates a tug of war between insurers and clinicians and rewards the healthcare system when our population is sicker. This is at the crux of Vermont’s efforts with the move to value-based payments through our All Payer Reform. We have a state-wide goal of improving quality of care and population health while limiting cost growth. At the center of our reform efforts is OneCare, Vermont’s accountable care organization (ACO). An ACO is a group of healthcare providers, including hospitals and doctors, who work together to provide high-quality, coordinated care. One of the key known success factors for an ACO is the involvement of multiple payers — in Vermont’s model we are bringing together Medicare, Medicaid and commercial insurers. Early results show our efforts are working with patients reporting timely care, good communication and coordination. The Milbank Quarterly reviewed the reform efforts of four states and found that Vermont has “the most promising results” with fewer hospitalizations and monthly savings per person versus their comparison groups. The committees of jurisdiction will continue oversight of our reform efforts and I’m happy to provide more information to anyone interested.

Our next community conversation with the Essex delegation is Saturday, Feb. 15 from 9 a.m. to 10:30 a.m. at Sweet Alchemy – hope to see you there!

Rep. Lori Houghton

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