Examining lessons from Vermont's universal healthcare system

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Vermont took the lead in efforts to implement federal and state healthcare reforms in May 2011 when Gov. Peter Shumlin signed legislation to implement Green Mountain Care, a single-payer, publicly financed, universal healthcare system.

There are lessons to be taken from Vermont's reform efforts, argues a perspective piece published in the New England Journal of Medicine.

"Vermont's administration provided information to residents, promoted transparency, and actively engaged citizens on all levels," writes author Laura K. Grubb, M.D., a Master of Public Health candidate at the University of Texas. Engaging key healthcare stakeholders has helped smooth the transition to large-scale reform on a larger scale, Grubb writes.

Another key to the success of Vermont's health reforms, she says, was the creation of the Green Mountain Care Board (GMCB), with jurisdiction over payment reform, insurance exchanges, rate setting, hospital-budget authorization, resource and workforce allocation, state formulary establishment, regulation of insurance carriers, and maintenance of a statewide quality-assurance program.

Vermont, one of 23 states plus the District of Columbia opting to establish its own state insurance exchange, will offer three tiers of insurance packages, Grubb writes. She quotes Robin Lunge, Vermont's director of healthcare reform: "The infrastructure is useful because it would build the portal we would use for single payer, including eligibility screening, enrollment processing, premium collection, claims administration, and claims payment."

Grubb also says Vermont has capitalized on federal financing opportunities, reducing waste and increasing residents' satisfaction.

"Vermont is progressive," said Grubb in the announcement from the University of Texas at Houston. "They didn't wait until each step of the Affordable Care Act had to be implemented. They voted on their own state-based reform system."

To learn more:
- read the piece in the New England Journal of Medicine
- read the announcement from the University of Texas

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