Well before the University of Massachusetts Medical School released their report on the projected cost of Green Mountain Care, Rutland Treasurer Wendy Wilton had run her own numbers. Now, in a Vermont Business magazine article, she comments on the report that we paid UMass $300,000 for. First of all, there is the difference in the estimated new taxes that would be needed to fund this plan. Wilton’s numbers had pointed toward a need for $1.8 billion in new taxes, while the report is putting that number at $1.6 billion. That is pretty close and the difference is accounted for by the fact that Wilton included a “5% reserve for losses as well as costs for in-migration and increased utilization, ” which the UMass estimate did not. This raises the question of whether the UMass report is engaged in a little wishful thinking by not taking into account such a possibility. Wilton also noted that the UMass report did not mention just how we are going to come up with the extra $1.6 billion in new taxes.
Another issue with the report is in the area of provider reimbursement:
To slow the growth of health care costs The Green Mountain Care Board recently capped hospital revenues at 4.0%. The UMass report goes further, capping provider reimbursements at 105% of Medicare levels for all services; though providers currently receive about 129% of Medicare reimbursements inclusive of private insurance and Medicaid. UMass’s recommendation means an 18.6% reduction in provider revenue. Reductions will impact access, services and job opportunities in Vermont’s health care field. And if Congress reduces Medicare reimbursement levels, all provider revenues will drop.
Finally, she questions the assumptions the report makes regarding federal funding and raises the question the financial risk the state may be taking by going down this road.