The Green Mountain Care Board ruled Tuesday that a New Hampshire urgent care company does not need further review of its plans to operate centers in Vermont.
The New London, N.H., company ClearChoiceMD had requested that the board make a determination whether its plan to open five centers in Vermont would trigger the certificate of need process.
In a letter to ClearChoice attorneys, the board concluded that the urgent care centers proposed by ClearChoiceMD do not trigger Certificate of Need (CON) thresholds “and as such are not subject to review.”
Urgent care facilities provide a lower-cost alternative for people with non-life-threatening injuries or illnesses, such as fevers, infections or fractures, who can’t get in to see their primary care doctor and don’t want to seek care in a hospital emergency department.
A shortage of primary care doctors throughout the United States has increased demand for urgent care services.
ClearChoice has already leased properties in Rutland, Burlington, Brattleboro, St. Albans and Barre. The company intends to open the Barre and St. Albans locations in June.
Central Vermont Medical Center in Berlin will open its own urgent care center in May. The hospital was not required to obtain a certificate of need either, because the standalone facility does not meet cost thresholds to trigger the oversight process.
The two urgent care centers in Barre would be just a short distance from one another on the Barre-Montpelier Road.
Northwestern Medical Center has plans to open an urgent care center in St. Albans as well, meaning the city will also have two centers. Fletcher Allen Health Care also operates a urgent care center in Burlington.
Hospital executives say they want the process to be regulated to ensure there will not be a duplication of services that will drive up health care spending because of fixed system costs.
ClearChoice executives say that without competition, hospital-owned urgent care centers have no motivation to lower prices.
Advocates for universal health care and hospital executives are concerned that ClearChoice requires upfront payments for care and will turn away those who can’t pay.
Hospital-owned urgent care centers would not turn away people who can’t afford their services.
Rep. Mike Fisher, D-Lincoln, recently introduced an amendment that would require urgent care centers to obtain a certificate of need from state regulators before opening new clinics in Vermont.
The House was expected to vote on the amendment late Tuesday night.
It’s unclear if the amendment passes whether it could be retroactively applied to block ClearChoice’s entry into the Vermont market. ClearChoice has made clear that they believe it can’t and are prepared for a legal battle.
Fisher, who chairs the House Health Care Committee, said his proposal doesn’t reflect an opinion on whether ClearChoiceMD or anyone else should be allowed to enter the market.
The certificate of need process is in place to ensure an intentional and reasoned build-out of the state’s health care system, and he believes that should apply to urgent care centers, Fisher said.
Monkton resident and Republican candidate for state representative Valerie Mullin says Fisher’s proposal would stifle competition in the health care industry and limit choice for Vermonters.
Mullin, 55, is a small business owner and first-time candidate. She intends to run on a property-tax reform and health care choice platform.
She is running for one of the two seats in the Addison-4 district, currently held by Fisher and Rep. David Sharpe.