Gov. Phil Scott has reappointed Robin Lunge, a lawyer with long experience in Vermont health care policy, to a six-year term on the Green Mountain Care Board.
Lunge, who grew up in Brattleboro, has been a member of the board since 2016 and now has a seat there through 2029. Scott, a Republican, reappointed her in 2023 to a one-year term. Her new appointment started on Oct. 1.
“I’m delighted to be able to serve Vermonters in this capacity,” Lunge said in an interview on Thursday. “I enjoy the work. It’s hard work, but I think it’s really important to ensure that Vermonters get the best value that we’re able to provide in health care.”
By statute, board members are chosen by the governor from a list developed by a nominating committee, composed of representatives from both the administration and Legislature.
The Green Mountain Care Board, created by the Legislature in 2011, has wide-ranging responsibilities overseeing key aspects of the state’s $6 billion-plus health care sector. Its members, bolstered by a 27-person staff, make decisions about hospital budgets and charges, commercial insurance rates and the construction of new health care facilities.
In 2022, the Legislature also gave the board a leadership role in creating a framework for improving the long-term financial sustainability of rural hospitals, which includes the development of a framework for payments based on overall expenses, sometimes called a “global budget.”
Lunge served as the state’s director of health care reform under Democratic Gov. Peter Shumlin between 2011 and 2016, during his push to develop a statewide single-payer health care payment system. After that goal was dropped, she was instrumental in development of the state’s current “all-payer model” agreement with the federal government.
That agreement makes an accountable care organization — currently just OneCare Vermont, a subsidiary of the University of Vermont Health Network — the vehicle for bundling payments and incentives from many different payers, including Medicare, Medicaid and some private insurance. The organization passes those funds on to hospitals and hundreds of other health care providers in the form of regular monthly upfront payments and end-of-year bonuses or penalties for agreed-upon health outcomes and health care quality-related metrics.
The current agreement, which went into effect in 2018, has been extended only through the end of calendar year 2024. To include Medicare payments in any statewide model after that, Vermont officials will need to apply to participate in a new payment reform program recently unveiled in broad detail by the Centers for Medicare and Medicaid Services.
The board will be working with the Agency of Human Services and health care providers on crafting the details of that application, which Lunge said she was excited about. “I’m looking forward to seeing how that all develops over the next few years,” she said.
Between 2003 and 2011, Lunge worked for the state Legislature as a nonpartisan lawyer specializing in health care, human services and Medicaid issues, as well as for the Center on Budget and Policy Priorities, a think tank in Washington, D.C.
Board chair Owen Foster said in an emailed statement that the organization as a whole was “thrilled” about Lunge’s reappointment, and her background in regulatory matters “has been invaluable to me as her colleague.”
“Vermonters have benefited greatly from Robin’s knowledge and commitment to improving Vermont’s healthcare system over her many years in public service,” Foster wrote. “This is good news for Vermonters, and we are grateful that we can continue working with Robin to improve access, affordability, and quality of health care for Vermonters.”
Corrections: A previous version of this story overstated the size of the Green Mountain Care Board staff and misnamed the Centers for Medicare and Medicaid Services.
