Why these independent physicians are wary of all-payer model

Some physicians are concerned about potential regulatory changes in Vermont this year, according to VTDigger.

These providers testified on two major policy proposals from Gov. Peter Shumlin (D) at the state's House Health Care Committee and the Senate Finance Committee, according to the report.

Here are the two major proposals, and why independent providers are concerned.

First, Gov. Shumlin has proposed a 2.35 percent tax on independent physicians and dentists, according to the report.
The VTDigger reports this tax will generate more than $10 million from physicians and more than $6 million from dentists. The federal government will match that with $20 million in funds to go toward Medicaid, according to the report. However, physicians say the financial burden of the tax outweighs the potential increase from improved Medicaid reimbursement for nearly all independent physicians.

For physicians who treat large Medicare populations, the Medicaid rates will have little to no benefit, according to physician testimonials cited in the report, and they will not be able to shift the cost of the tax to customers because they don't have enough power to negotiate with payers.

Second, Gov. Shumlin has proposed an all-payer model to promote the formation of accountable care organizations. 
This model would promote the OneCare ACO, which is run by the University of Vermont and Dartmouth Hitchcock medical centers, in Burlington, Vt., and Lebanon, N.H., respectively, according to the report. It could also promote a partnership between OneCare and other stakeholders, including community health centers and independent physicians, according to the report.

However, physicians who are wary of this are primarily concerned about working under a hospital-owned ACO and about the paperwork associated with it, according to the report.

 

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