[T]he state says it is reducing how much it pays the University of Vermont Medical Center and six other hospitals to treat Medicaid patients.
The Department of Vermont Health Access released a document Thursday saying it would trim the reimbursement rate to what it pays Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire.
Dartmouth-Hitchcock sued the state of Vermont in November, claiming it was not paying the hospital as much as Vermont hospitals to treat Vermont’s Medicaid patients. Forty percent of Dartmouth-Hitchcock’s patients come from Vermont, but not all are insured through Medicaid.
On Monday, the Green Mountain Care Board shared a spreadsheet with VTDigger that was labeled as coming from the Department of Vermont Health Access. The Vermont Association of Hospitals and Health Systems, which represents all Vermont hospitals, shared it with its members and the board.
The spreadsheet shows that six other hospitals would also see a rate cut: Rutland Regional Medical Center, Central Vermont Medical Center in Berlin, Northwestern Medical Center in St. Albans, Southwestern Vermont Medical Center in Bennington, Brattleboro Memorial Hospital, and the Brattleboro Retreat.
UVM Medical Center and the other hospitals’ rates will now be set at 75 percent of what Medicare (a separate federal program with higher reimbursement rates) pays similar hospitals. UVM had been receiving about 87 percent, and Dartmouth-Hitchcock was getting 75 percent.
Officials for UVM Medical Center were not available for comment Monday afternoon.
Al Gobeille, the chair of the Green Mountain Care Board, which regulates hospital budgets and commercial insurance rates, said he learned about the decision Friday. He said he is still trying to understand the details.
A spokesperson for the Department of Vermont Health Access was not immediately available for comment. The announcement Thursday said the change is being made in accordance with Vermont’s state plan for Medicaid.
“We are very concerned about this unexpected, mid-year cut,” the hospital association said Monday in an emailed statement to VTDigger. “This is an example of the unpredictability of health care finance, and of the volatility that can make it challenging for our hospitals to meet the health care needs of their communities. If Vermont is to succeed in health care reform efforts, it’s critical that Medicaid be a reliable and predictable partner.”
Vermont’s announcement Thursday also included an increase in how much the Medicaid program will pay smaller, rural hospitals for the same services. Those facilities, called critical access hospitals, will receive about 112 percent of what Medicare pays similarly situated hospitals, an increase from about 93 percent.
The analysis from the Department of Vermont Health Access lists eight critical access hospitals that will see a rate increase: Copley Hospital in Morrisville, Gifford Medical Center in Randolph, Grace Cottage Hospital in Townshend, Mount Ascutney Hospital in Windsor, North Country Hospital in Newport, Northeastern Vermont Regional Hospital in St. Johnsbury, Porter Medical Center in Middlebury and Springfield Hospital.
It is unclear whether the rate changes will affect outpatient procedures, inpatient procedures, or both.
The changes are all described as effective retroactively to March 1.
Hospitals are in the middle of fiscal year 2016, which runs from Oct. 1 to Sept. 30. They have been preparing budgets for fiscal 2017.
