Blue Cross Blue Shield of Vermont submitted a letter of recommendation to state regulators for the project, called the Green Mountain Surgical Center, on Thursday.
“Our members benefit from having a robust network that offers a choice of settings in which they can receive care,” wrote Andrew Garland, the vice president of client relations and external affairs for Blue Cross.
“For this reason, we credential and contract with any qualified provider that can offer high-quality care to our members at competitive prices, as collectively we work toward reducing overall health care expenditures in Vermont,” Garland wrote.
He said in an interview Friday: “Blue Cross Blue Shield is a customer-focused organization, and our customers, both our members and employer groups, have asked us to support projects like this, that offer them more access and more choice.”
Blue Cross insures about 90 percent of people who use Vermont Health Connect and more than 72 percent of the entire [commercial insurance market]. Blue Cross also administers the self-insured plan for state workers and workers at the University of Vermont Medical Center.
State Category | Insurance Market Competitiveness | The Henry J. Kaiser Family Foundation
MVP Health Care, which insures a minority of customers who use Vermont Health Connect, endorsed the project [in January]. Cigna, which administers plans for self-insured companies like Burton Snowboards, [endorsed the project] on March 6.
Amy Cooper, the main spokesperson for the project and the executive director of HealthFirst, said the insurer’s opinion “matters a lot” because of its influence in Vermont’s commercial health insurance market.
“We are very encouraged to see Blue Cross Blue Shield join with the other commercial insurers in the state to support a lower-cost, high-quality option for their members,” she said.
The proposed surgical center has been [tied up in a regulatory process] in front of the Green Mountain Care Board for nearly two years. Investors are proposing to offer basic surgeries, such as knee repairs and hysterectomies, and other procedures such as colonoscopies and treatment for spinal pain.
Cooper said the project will save customers money because Medicare reimburses these types of surgical centers about 50 percent to 60 percent of what they reimburse hospitals for the same surgeries.
She said these types of surgical centers have figured out how to “streamline the operations and supplies” so they can stay in business while being paid less than the hospitals.
The Vermont Association of Hospitals and Health Systems, which represents all of Vermont’s hospitals, and Northwestern Medical Center in St. Albans have been intervening in the regulatory case.
They have said the project would reduce their profits, which the hospitals in turn use to provide services like running emergency rooms.