Green Mountain Care Board FY 2019 Budget June 27, 2018
The Role of GMCB Health insurer rate review (including the Exchange) Hospital Budgets ACO Budgets VITL Budget Major capital expenditures (Certificate of Need) Health Resource Allocation Plan (HRAP) Implementation of APM ACO Oversight, Certification, Rule 5.0 (Act 113) The Green Mountain Care Review/modify/approve plan designs for Vermont Health Board is charged with reducing Connect the rate of health care cost growth in Vermont while Data and Analytics (VHCURES, VUHHDS and APM Analytics) ensuring that the State of Primary Care Advisory Group Vermont maintains a high Billback Fund Management quality, accessible health care Expenditure Analysis system. Cost Shift Report Outreach and Education/ OML Approve State HIT and Health Care Workforce Plan Prescription Drug List Per Act 165 2
FY 2019 SUMMARY & HIGHLIGHTS Green Mountain Care Board FY 2019 Budget • $211k base, ongoing reduction in contracts • Requested by House Appropriations in MISSION: The mission of the Green Mountain lieu of eliminating three limited service Care Board (GMCB) to regulate, innovate, and positions from our base evaluate Vermont's changing health care system to improve the health of the population, provide access to high quality health services for all • 4.1% General Fund reduction residents of the state, and ensure the affordability of health care by reducing the rate of growth in health care costs. • 5 Board, 5 Exempt, 22 Classified positions • Performance Year 1 All-Payer Model GMCB FY19 • Alignment of regulatory responsibilities General Fund , 2,032,469 , 25% • Process Updates: Rate review, hospital budget Billback , 3,386,789 , 42% • Updated, more robust data analytics initiatives HIT Fund , 60,000 , 1% • Health Care Advocate increased by House Appropriations to level fund with FY18 Global Federal Funds , Commitment , 70,000 , 1% 2,495,518 , 31%
FY18 As Passed to FY19 As Passed 4
Total Appropriations $10,000,000 $9,500,000 $9,000,000 $8,500,000 $8,000,000 $7,500,000 $7,000,000 $6,500,000 $6,000,000 $5,500,000 $5,000,000 FY15 FY16 FY17 FY18 FY19 5
Appropriation by Fund Source 4,500,000 4,000,000 3,500,000 3,000,000 2,500,000 2,000,000 1,500,000 1,000,000 500,000 - FY14 FY15 FY16 FY17 FY18 FY19 General Fund Global Commitment Federal Fund Interdepartmental Funds Special Funds 6
RBA: Rates for VT Health Connect Products BCBS – FY18 $14.4M savings to VHC MVP – FY18 $1.8M savings to VHC insured population insured population 14.0% 18.0% 16.0% 12.0% 14.0% 10.0% 12.0% 8.0% 10.0% 8.0% 6.0% 6.0% 4.0% 4.0% 2.0% 2.0% 0.0% 0.0% 2015 2016 2017 2018 2015 2016 2017 2018 Approved Proposed Approved Proposed 7
RBA: Hospital Budget Review All 14 Hospital Systems in Vermont Proposed & Approved Hospital Budget Proposed & Approved Annual Price Rate (price & utilization) Increases 5.5% 7.0% 6.0% 4.5% 5.0% 3.5% 4.0% 2.5% 3.0% 1.5% 2.0% 1.0% 0.5% 0.0% 2015 2016 2017 2018 Proj 2015 2016 2017 2018 Proj -0.5% Approved Proposed Target Approved Proposed 8
Pre-GMCB Average % Increase 7.3% 9
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