President of Blue Cross Blue Shield of Vermont Letter to state legislatorsBusiness and Healthcare Leaders Explain This Week Insurance companies’ worrying financial situation: They’ve lost $100 million in five of the past six years. And recently, the company lost more than $13 million in October alone, the largest paid insurance claim in its history.
“As a direct result of rising prices for medical services and drugs, Vermont’s commercial health insurance premiums are already high and are increasing at an unsustainable rate, but they are not covering the cost of health care,” the insurance company president said. said Don George, CEO and CEO.
According to federal data, Vermont insurance premiums are highest Applies to employer-based health insurance in any state. After years of double-digit increases, Blue Cross this year raised rates by about 20% for individuals and 23% for small businesses. Blue Cross VT says the state’s demographics — older people living in rural areas — are only part of the reason for higher premiums.
“We really want to dispel that myth, because you can’t solve a problem by blaming the wrong causes,” said Blue Cross spokeswoman Sarah Teachout.
Owen Foster, chairman of the state’s health care regulator, the Green Mountain Care Commission, agreed: “Demographics are not going to solve the problem.” “You can’t point that out and say there’s nothing you can do about it.”
Demographics alone won’t solve the problem…you can’t point that out and say nothing can be done.
Owen Foster, Green Mountain Care Board Chair
Teachout looked at comparative data from Blue Cross insurance companies across the country and said that given Vermont’s demographics, health care costs in the state are still 26% higher than in the rest of the Northeast.
hospital charges
Blue Cross says a big reason for the state’s disproportionate costs is the affordability of Vermont’s hospitals and health care system as a whole. Here are the fees charged for outpatient care at Vermont hospitals: The highest level in the country.
“Hospital costs account for about half of health care spending and are the driving force behind soaring health care costs,” said Julie Wasserman, an independent health care consultant. She writes about the following expenses University of Vermont Medical Center Emergency Room Carethe largest hospital in the state; Top 10% of most expensive outpatient services in the country.
Annie Mackin, a spokeswoman for UVM Health Network, which also includes UVM Medical Center, said the hospital is working to reduce costs, including recently cutting radiology fees by 25%.
“We believe there is a path forward to address affordability in Vermont and move toward a value-based system,” she said in an emailed statement. “[We] We want to work with governments, insurers and the business community to address this issue more broadly. ”
Mackin also said there are other factors contributing to Blue Cross VT’s financial position besides medical prices.
A letter from an insurance company warning of instability in the insurance company. The financial situation worsened weeks after UVM Health Network announced cuts to patient services to comply with budget mandates from the Green Mountain Care Commission. The order required hospital systems to limit their operating revenues and reduce the amount they can bill private insurance companies by 1%.
Lexi Krupp
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vermont public
recent Corporate bond disclosure report It shows UVM Medical Center and its affiliated hospital group earned $86 million in net income from operations last fiscal year. Regulators pushed for higher revenue caps to control health care prices.
“Our health care financing system is broken, so the Blue Cross letter is like a flashing red light,” said Mike Fisher, the state’s chief health care advocate.
Blue Cross VT leaders say if no changes are made to curb the state’s soaring health care costs, premiums will continue to rise at an unsustainable rate.
“It’s outrageous. People can’t afford it,” said Foster, of the Green Mountain Care Committee. “But if they don’t do that, Blue Cross faces a very serious bankruptcy. And if they go bankrupt, it’s Armageddon in that they won’t be able to pay providers.”
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