Progress and setbacks for health reform in Vt. - WCAX.COM Local Vermont News, Weather and Sports-

Progress and setbacks for health reform in Vt.

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At a press conference this week, Gov. Peter Shumlin announced the launch of a new program to curtail health spending.

"In order to do health care right, we've got to get this right," said Shumlin, D-Vermont.

In the past, the only reward for a hospital that came in under expected costs was a lower budget in the next year. Now, networks of insurers and providers will be able to split a portion of savings if quality care measures don't slip as a result.

Green Mountain Care Board President Al Gobeille says there's evidence that data-based streamlining will create savings, but says there's a bigger benefit.

"What health care needs is better organization and this provides the opportunity to do that," Gobeille said.

After three years, penalties will be introduced for those that come in over-budget. The change begins to pave the path toward single-payer, as the 2017 plan must be scrapped if officials can't prove it will deliver on promises to contain costs.

With a major deadline looming for the state's online marketplace, Saturday will be the last day to enroll for April coverage.

The user experience continues to be a rough ride for some.

"I feel beaten and battered," said Susan Rixon, a frustrated consumer. "I feel like I have done everything I was supposed to do in this entire process and I'm still running into road blocks."

We first introduced viewers to Rixon in January. She paid her premiums on time, despite never receiving a bill before doing so and couldn't confirm her coverage. Rixon did eventually receive proof of insurance and continued to send checks despite never receiving an invoice. That didn't stop Health Connect administrators from canceling her policy for nonpayment. No one can definitively tell her why.

"Three different scenarios, three different people that I've spoken to there tell me different stories as to why I was terminated," Rixon said.

She says she can't understand why neither the state nor MVP called her before terminating the policy.

Her new plan promised to save her $1,000 every month, but thus far she says it's also come with plenty of headaches. After more than four hours on the phone, Rixon says she did manage to resolve her problem.

Spokespeople for Vermont Health Connect told us they're unaware of anyone experiencing similar issues.

We did reach out to carriers to determine how many people have had coverage canceled since Jan. 1. Blue Cross Blue Shield spokespeople say they have not canceled a single policy. MVP could not provide numbers on cancellations, but in a statement, spokespeople indicated that Vermont Health Connect determines if members have paid and add that wrongfully terminated individuals are reinstated.

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