Healthcare (Healthcare Workforce)

This Vermont bill (S 126) reforms how healthcare is paid for and delivered by establishing reference-based pricing as the primary payment method by 2027. It directly affects hospitals, doctors, insurers, and patients by setting maximum payment rates based on Medicare benchmarks, aiming to control costs while ensuring providers remain financially stable. Key mechanisms include requiring the Board to implement payment models like bundled payments, global budgets, and reference-based pricing to reduce cost-shifting and improve care coordination. The law also mandates standardized metrics to track progress on goals like reducing healthcare disparities, expanding primary care access, and supporting healthcare workforce retention. These changes apply statewide to all commercial health insurance and provider reimbursement systems.

This bill expands the scope of practice for optometrists in Vermont by creating an "advanced therapeutic procedures specialty." Qualified optometrists with this specialty may now perform specific procedures, including removing small superficial eye lesions (like chalazia), certain laser treatments (such as for cataracts), and targeted injections for conditions like chalazia or vision testing. The bill also explicitly prohibits optometrists from performing retinal surgeries, corneal transplants, or injections into the back of the eye. Optometrists seeking this specialty must complete additional continuing education hours focused on advanced procedures. The changes aim to clarify and modernize what optometrists can legally provide while maintaining patient safety through defined boundaries.