Vermont
Julie Wasserman: How to control Vermont’s skyrocketing hospital costs
This commentary is by Julie Wasserman, MPH, of Burlington. Wasserman is an unbiased well being coverage marketing consultant who labored for Vermont state authorities for over 25 years.
The price of well being care has develop into unaffordable for a lot of Vermonters. The newest family survey commissioned by the state discovered that 44% of privately insured Vermonters are “under-insured.” This implies they’ve insurance coverage protection however have issue affording their deductibles and out-of-pocket prices. Because of this, they forgo wanted medical care.
Hospital prices comprise roughly half of each well being care greenback spent in Vermont. Just lately proposed double-digit hospital price will increase for FY23 will devour an ever better share of well being care spending, exacerbate the affordability disaster, and additional deprive community-based companies of wanted income and sources (main care, psychological well being, residence well being companies), a lot of which has the potential to forestall pricey hospitalizations. World budgets are a way for controlling and reducing hospital prices to appreciate financial savings that may be redirected to community-based companies in addition to assist decrease insurance coverage premiums.
World budgets are an alternate fee mannequin wherein hospitals are paid a prospectively decided quantity for all inpatient and outpatient companies to serve a affected person inhabitants in a given 12 months. World budgets cowl the precise working prices of hospitals (separate from their capital bills) and are primarily based on present and historic utilization of medical companies. Previous to figuring out the quantity of worldwide funds for every hospital, costs would first should be standardized.1 With out the standardization of costs as a primary step, hospital international budgets would lock in present irrational pricing.
Hospital costs have little foundation in actuality. Expenses are set arbitrarily and range wildly for the very same service. The time period used to explain this phenomenon is “worth variation.” A main instance of worth variation is obstetric look after a routine new child supply which prices $5,385 at one Vermont hospital however solely $2,192 at one other Vermont hospital.
A latest report from the RAND Company on hospital worth transparency for the interval 2018-2020 discovered UVM Medical Heart set its industrial costs (inpatient and outpatient mixed) at greater than 300% % of Medicare costs. This implies employers and personal insurers pay greater than thrice the relative quantity Medicare would pay for a similar companies. Likewise, Southwestern Hospital’s costs tally at 287% of Medicare costs, and Rutland Hospital’s at 279%. (RAND observes that relative costs have the benefit of incorporating all of Medicare’s changes for case combine, wages, and inflation and are comparable throughout each inpatient and outpatient companies).
Conversely, Mary Hitchcock Memorial Hospital set its charges at 177% of Medicare costs (a bit greater than half of UVM Medical Heart’s costs), Porter set its charges at 155% of Medicare costs, and Mt. Ascutney (the bottom) at 117%. The RAND research states, “Little or no variation in costs is defined by every hospital’s share of sufferers coated by Medicare or Medicaid; a bigger portion of worth variation is defined by hospital market energy.” How can Vermont justify the excessive costs at UVM Medical Heart, Southwestern, Rutland and others? (See desk beneath.)
One method to standardizing hospital costs is “reference-based pricing” the place the value of a given process is identical whatever the supplier.2 The value for a service could be decided by indexing (or referencing) it to a a number of of the Medicare price since Medicare charges are a well-established nationwide customary, clear, linked to high quality measures, and most significantly, usually are not topic to bargaining leverage.3 Reference-based pricing can degree the enjoying subject and has the potential to distribute well being care {dollars} extra equitably amongst Vermont’s hospitals.
Vermont’s well being care system continues to be based totally on fee-for-service funds regardless of the All Payer Mannequin’s greatest efforts. Reference-based pricing is a fee-for-service instrument that may present a path to value-based international hospital budgets, foundational to the long-term monetary sustainability of Vermont’s hospitals.
1 The Inexperienced Mountain Care Board concurs that the worth charged by particular person suppliers (not quantity or utilization) is the first driver of elevated medical prices.
2 Montana employed reference-based pricing benchmarked to Medicare charges for its state staff and has seen no improve in premiums, out-of-pocket prices, or reductions in its profit plan for six consecutive years resulting from financial savings. ($48M in financial savings from 2017-2019, and ongoing.) The Vermont State Auditor’s report discovered that Vermont might doubtlessly save $16.3M yearly if it carried out reference-based pricing for state staff.
3 The Colorado Supreme Courtroom just lately dominated in favor of a affected person paying the “cheap worth” of care supplied as an alternative of the hospital’s chargemaster worth. The affected person was coated by a reference-based worth “well being plan” which is more and more well-liked amongst self-insured employers enabling them to keep away from arbitrary and typically inflated hospital costs.
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Phil Martelli, Jr.’s opening statement after Bryant’s win vs. Vermont
Phil Martelli, Jr.’s opening statement after Bryant’s 73-53 win vs. Vermont men’s basketball.
SMITHFIELD — Bryant men’s basketball’s addition to the America East three years ago didn’t alter the traditional powers.
Vermont captured the last two league titles to finish off a stretch of five crowns in six years for the Burlington program. Bryant, before joining the conference, largely had no history with its northern neighbors outside of a home-and-home series in 2013-14.
The Bryant-Vermont matchup was reintroduced in January of 2023 with Vermont winning all four meetings since they became conference foes. Bryant halted that run and redirected the league’s authority on Saturday night at the Chace Center.
Bryant (8-9, 2-0) blistered the Catamounts with an early run and thumped Vermont in the second half for a 73-53 triumph behind Connor Withers’ 19 points. The six-year guard caught fire at the end of the first half and shot 8-14 for the game. Bryant only kept that potent scoring going in the second half.
“I don’t even know my record against them,” Withers said of Vermont. “I’ve lost a lot more than I’ve won against them. And then losing in the championship, I’ve got a lot of respect for that team. They’re top of the conference every year, the team to beat every year. It does feel good.”
Withers transferred to Bryant from UMass Lowell last season. The guard lost to Vermont, 72–59, in the 2022-23 conference championship. Saturday’s win can’t erase that feeling, but his shooting can pace a conference run for Bryant this winter.
“It’s just another win and it’s just one win,” Withers said. “As good as it feels to beat them, it only counts for one win. It doesn’t count for five wins in the conference, it counts for one win. As good as it feels, it doesn’t mean too much if we don’t handle business next week and the next game that we play.”
The Bulldogs trailed, 15-5, before trading 3s with Vermont on six straight possessions. They withstood Vermont’s best punch through the first 12 minutes of the game and trailed just 24-17 on Withers’ second 3-pointer.
The shot from the wing got Withers going as he added his third trey of the contest just a few minutes later to give Bryant its first lead, 28-26, with 4:20 to play in the frame. He added another long jumper and a layup high off the glass for a personal 7-0 run.
“It’s the discipline,” Bryant coach Phil Martelli Jr. said of Vermont’s success. “I would bet there’s not a lot of games where they’ve turned it over that much (17 turnovers) and haven’t turned the opponent over. The game was played on our terms, outside of those first minutes, which is hard to do against them. They usually play it on their terms and then you get into that game trying to beat them at their game. That’s hard to do, as we’ve seen.”
Withers’ sequence started a Bryant run, 23-6, that ended only from the halftime horn. But the Bulldogs didn’t stop, and out of the break scored 20 of the first 22 points. All told, Bryant’s supremacy was a 43-8 run over 17 minutes of play.
“I was concerned about us settling,” Martelli said. “And then we came out, we got to the rim, we scored, and we’re able to get some layups and do some things. … And that goes to, we have guys that have the ability to do multiple things.
“That was key for us. I think being able to start that half and getting some layups, obviously, getting the stops along with it.”
Barry Evans and Rafael Pinzon both chipped in 13 points. Earl Timberlake added a dozen with six rebounds, four assists and four steals as Bryant shot 44.6% from the field and was 11-for-27 from beyond the arc.
“I get it, we haven’t beaten them,” Martelli said. “They are the standard. They are flat-out the standard. But it’s [only the second conference win].
“It’s good we beat Vermont because that’s who we played today. We got number two, now let’s get number three.”
Bryant vs. Vermont all-time
Nov. 16, 2013: Bryant 87, Vermont 64
Nov. 26, 2014: Vermont 73, Bryant 47
Jan. 5, 2023: Vermont 74, Bryant 64
Feb. 25, 2023: Vermont 70, Bryant 66
Jan. 27, 2024: Vermont 67, Bryant 57
Feb. 24, 2024: Vermont 65, Bryant 48
jrousseau@providencejournal.com
On X: @ByJacobRousseau
Vermont, the Green Mountain State, is known for its mountain ranges, which tourists can appreciate at popular parks, such as Smuggler’s Notch State Park. However, with over 800 lakes in the state, you can’t discount the plentiful water bodies available for recreation. Vermont is a haven of nature with lakes such as Arrowhead Mountain Lake, Lake Memphremagog, and Lake Champlain, which are tourist and resident favorites due to their historical legends and thrilling water activities. This state is filled with more beautiful lakes and communities by the water than you can imagine, from the shire town of Newport to the historic terrains of Whitingham. Discover the best lakeside towns to visit in Vermont on your next vacation.
Shelburne
Shelburne is one of Vermont’s most visited locations, just seven miles to the south of Burlington. It is set along the shores of Lake Champlain and got its name as a form of tribute to a great British Parliamentarian and Prime Minister, William Petty, 2nd Earl of Shelburne. The community is known for its early agricultural enterprise before diversifying into shipping following the War of 1812. The Shelburne Museum documents the events of the war and other happenings that shaped the area’s development. It also houses thousands of decorative items, steamboats, and carriages that paint a vivid picture of its past.
Stroll in the cool of the day to Shelburne Farms, where you can find much more information about the storied agricultural essence that formed Shelburne. The Farmer’s Market is just a short walk away, and the same goes for Shelburne Vineyards and Orchards, which supply the Farmer’s Market. To get close views of Lake Champlain, take a trip to Shelburne Town Beach, where you can enjoy evening strolls and picnics. Hike across the Shelburne Bay Park hiking area to get more scenic views of the creek.
Whitingham
Whitingham outwits you with all its charm, from its lakeside views to its serene outdoors. It is known as the birthplace of Brigham Young, the second president and prophet of The Church of Jesus Christ of Latter-Day Saints, who was born in 1801. The community has a monument erected to this effect, the Brigham Young Monument.
The atmosphere that envelopes Whitingham is truly lovely, and there are opportunities to get a whiff of the natural environment. Take the historic tour for an eye-opening experience. What is even more interesting about the historic tour is that you can take it by car or bike. Learn more about Whitingham at the Whitingham Historical Society before taking a hike at the Catamount Trail.
Fairfield
Fairfield is a brimming lakeside community on Fairfield Pond lake with a rich heritage. It is a 446-acre body of water on the northwest of Fairfield. The Fairfield area is known as the birthplace of Chester A. Arthur, the 21st President of the United States, Fairfield celebrates its presidential legacy at the Chester A. Arthur Historic Site. This preserved homestead offers visitors insight into the life of one of America’s lesser-known leaders and the region’s history during the mid-19th century.
The Fairfield Community Center, housed in a 19th-century school building, is another noteworthy site. It reflects the town’s enduring dedication to community engagement and historic preservation. For those interested in Vermont’s rural heritage, Fairfield Pond provides a serene escape, surrounded by open fields that are reminiscent of the city’s agricultural roots. Apart from the ancient landmarks, you can also explore natural settings that make the community more fun. These include the Metcalf Pond and the Missisquoi Valley Rail Trail.
Charlotte
Along the eastern shores of Lake Champlain, one of Vermont’s picturesque lakeside towns, seizes the attention of many. Charlotte is a quaint Vermont settlement that is rich in historical significance and natural allure. It is perhaps best known for the Charlotte-Essex Ferry, which has connected Vermont to New York since the early 19th century, with breathtaking views of the water and the Adirondack Mountains. Charlotte’s history is documented at the Old Brick Store, a famed general store that has served as a community hub since 1853 and continues to provide locally crafted goods and treats.
The agricultural economy that once shaped Charlotte is still very much alive. Philo Ridge Farm and Adam’s Berry Farm are two of the most popular, and they serve local produce to the market. The farms are quite serene and are maintained by very hospitable families who are willing to indulge in conversations about Charlotte’s early days. While you are out, be sure to check out Mount Philo State Park. The park has a reputation that speaks for itself. It is Vermont’s oldest state park, and you can also enjoy stunning views of the Adirondacks and Lake Champlain. The spaces are equipped with benches and rails where you can just unwind and take pictures while enjoying the view.
Newport
Newport is a unique settlement in Vermont. Although it is located on the shores of Lake Memphremagog, Newport is the shire town of Orleans County with the second largest population in the county with just over 4,000 people and also has the smallest geographical area in the county (19.68 square kilometers).
The community’s crown jewel, the Goodrich Memorial Library, is a stunning example of Victorian Gothic architecture and a repository of ancient information. Visitors can explore its intricate design and learn about Newport’s cultural heritage through its archives.
Lake Memphremagog itself is steeped in legend, with tales of Memphré, the creek’s mythical creature, adding an air of mystery. Waterfront attractions like the Gateway Center celebrate the river’s significance, while outdoor enthusiasts can enjoy the scenic vistas and hiking trails along the Beebe Spur Rail Trail and the Prouty Beach and Campground.
Addison
If you are wondering what early New England life felt like, then you need to add Addison to your list of lakeside Vermont places to visit. Addison greets you with New England charm and a whole lot of options on where to tour. The city’s crown jewel is the Chimney Point State Historic Site, located where Lake Champlain narrows at the Crown Point Bridge. This site highlights the area’s significance during the French and Indian War and its role in early European settlement.
Snake Mountain Trail is always a point of interest for travelers because of its picturesque setting and location, and it is easily accessible to all. The trail is flanked by trees that cover hikers from the sun and form a beautiful picture backdrop of leaf canopies. It is good for evening strolls and hangouts. Additionally, the D.A.R. State Park is a great spot for wildlife and nature lovers. The park has open spaces for picnics and extensive hiking trails, and its proximity to the lake makes it ideal for water and winter sports. The reflection of trees on the waters creates a picture-perfect view and allows for a connection to Vermont’s natural heritage.
Ferrisburgh
Ferrisburgh is near Lake Champlain, Little Otter Creek, and Kingsland Bay, which makes a no-brainer when mentioning the best lakeside town in Vermont. Founded in 1762, Ferrisburgh is steeped in history and complemented by commercial landmarks.
Rokeby Museum, the most documented underground railroad and also a National Historic Landmark, stands as a poignant reminder of Vermont’s abolitionist movement and its role in the Underground Railroad. The museum’s preserved buildings and exhibits give an intimate look at the lives of the Robinson family, who championed social justice causes. Dakin Farm is another attraction with cultural significance. It is a family-owned, multi-generational business that has been running since 1792. Visitors will enjoy a trip to Kingsland Bay State Park, where they can spend the afternoons just chilling or having great conversations in a nice and cozy environment.
Whether you are visiting to learn more about the famed stories of Shelburne or exploring history at Fairfield, Vermont is replete with attractions that can help you declutter and feel at ease. Each area has its own heritage, creating diversity at every turn, from the pristine waters of its lakes to the picturesque backdrop of its parks. Vermont caters to the feelings of every traveler and creates a wonderful experience for anyone looking to relish the charm of a lakeside town.
The 2024-2025 Vermont high school winter season has begun. See below for scores, schedules and game details (statistical leaders, game notes) from basketball, hockey, gymnastics, wrestling, Nordic/Alpine skiing and other winter sports.
TO REPORT SCORES
Coaches or team representatives are asked to report results ASAP after games by emailing sports@burlingtonfreepress.com. Please submit with a name/contact number.
►Contact Alex Abrami at aabrami@freepressmedia.com. Follow him on X, formerly known as Twitter:@aabrami5.
►Contact Judith Altneu at jaltneu@gannett.com. Follow her on X, formerly known as Twitter: @Judith_Altneu.
SATURDAY, JAN. 11
Boys basketball
Games at 2:30 p.m. unless noted
Hartford at Middlebury, 12:30 p.m.
Missisquoi at Lake Region, 1:30 p.m.
Milton at BFA-St. Albans
Williamstown at Northfield, 6:30 p.m.
Girls basketball
Games at 2:30 p.m. unless noted
Danville at Winooski, 11 a.m.
Spaulding at Milton, 11:30 a.m.
Mount Mansfield at Colchester, 12:30 p.m.
Otter Valley at Mount Abraham, 12:30 p.m.
Montpelier at Stowe, 1 p.m.
Richford at Enosburg
Peoples at Twinfield/Cabot
Brattleboro at South Burlington
Burr and Burton at Champlain Valley
Rutland at St. Johnsbury
Williamstown at BFA-Fairfax, 3:30 p.m.
Boys hockey
Essex at Hartford, 2 p.m.
Burlington at U-32, 2:30 p.m.
Mount Mansfield at St. Johnsbury, 3 p.m.
Milton vs North Country at Jay Peak, 4 p.m.
Harwood at Stowe, 4:15 p.m.
South Burlington at Champlain Valley, 4:45 p.m.
Brattleboro at Woodstock, 6:45 p.m.
Rice at Burr and Burton, 7 p.m.
Spaulding at Middlebury, 7 p.m.
Rutland at Colchester, 7:30 p.m.
Girls hockey
Spaulding at Rutland, 11 a.m.
Woodstock at Brattleboro, 4:45 p.m.
Harwood at Burr and Burton, 5 p.m.
Rice at Burlington/Colchester, 5 p.m.
Stowe at Middlebury, 5 p.m.
Essex at BFA-St. Albans, 7 p.m.
U-32 at Kingdom Blades, 7 p.m.
Gymnastics
Harwood at Burlington, 2 p.m.
Montpelier, St. Johnsbury at South Burlington, 7:30 p.m.
Wrestling
Michael J. Baker Classic at Essex
MONDAY, JAN. 13
Boys basketball
Games at 7 p.m. unless noted
Randolph at North Country, 6:30 p.m.
Harwood at U-32
Winooski at Twinfield/Cabot
Northfield at Milton
Brattleboro at Champlain Valley
Thetford at Williamstown
Oxbow at Hazen
Girls basketball
Vergennes at BFA-Fairfax, 7 p.m.
Essex at Burlington, 7:30 p.m.
(Subject to change)
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