MEMBERS ABSENT:

Also Present:

Legislative and Joint Fiscal staff, members of the Administration, and the public.

Meeting Recorded:

CD HCRC 8/30/07, CD #1

Documents Distributed:

1.          Convene, Review and Approve 7/17/07 and 8/22/07 Meeting Minutes          CD #1, TR 1

Rep. Maier convened the Commission meeting at 3:05 PM.  We will wait to approve the sets of minutes until the next meeting.

2.               Blueprint for Health

a.     Executive Director: introduction and comments                                       Craig Jones   

b.     Overview of status/key activities of other pilot communities      Sharon Moffat

c.     Chronic Care Information System                                                  Sharon Moffat

                                         i.     Update, including initial sequence of communities

                                       ii.     relationship between registry and EMR

Documents distributed:

• Blueprint map
• Blueprint Implementation Highlights, Summer 2007

Sharon Moffatt introduced Craig Jones, the new Blueprint Director.

Dr. Jones: Goals are to move ahead steadily, using systems-level approach, working towards designing a care model. Build a sustainable care model. Need to fundamentally change the system of preventive care. Bennington is the pilot.

They are addressing the CCIS issues that are being raised.

Second pilot: hope for July 2008.

Maier: Concern: APS system and Medicaid—two different disease management systems. Need to monitor roll-outs carefully.

Besio: APS, as Medicaid, Josh, Susan and Blueprint staff are coordinating closely—at least in the pilot communities.

Maier: Doctors want the disease management money in their offices—and APS is not this model.

Discussion continued re this programs challenge.

Q for Dr. Jones: The vision is a huge systems change. What do you see as the major challenges?

A: The advantage is that political will is driving this in Vermont—this is important. There is the consequent money to start and stimulate, and to transition to a self-sustaining model. Commitment must continue.

Q: What does the political will have to deliver? Increase budget? Bring the insurance companies to the table? Move the doctors along?

A: Here are the stumbling blocks:

a.  Can we align $$ incentives with our changes?

b.  Nature of the IT platform. Must be usable, not a block. We have a good start with the IT.

Those are the two biggest challenges.

Comment: People in the community have to control the increase in costs.

A:  When do really good care for chronic illness, over a large population, you rarely reduce costs.  May shift the costs…

3.          Catamount Health implementation                                                     Susan Besio

a.     BISHCA approval of rates, benefit design and carrier plans

High level comparison of benefits: MVP and Blue Cross

b.     Marketing and enrollment plan

                          i.          Name, logo, materials development

                         ii.          Marketing campaign: state, carriers

c.     Premium assistance implementation

Documents distributed:

• Catamount Health Plan Benefits
• Green Mountain Care logo
• Green Mountain Care, Milestones Timeline for Vermont Marketing

Besio:

BISHCA has approved rates: MVP and BCBS rates will be the same.

Full cost:  $393.11/single

$786.22/two adults

$1,100.70 family

Comparison of benefit plans also on web site.

Marketing and Enrollment:

Introduced Green Mountain Care logo and tag.

Around Sept. 16, tool kits to community liaisons, all legislators will also receive.

Discussed milestones timeline for launch, various milestones. Those who have already signed up to get information will receive materials Sept. 10.

Premium Assistance Implementation:

Staff in place, trainings are scheduled Other systems on track

A special team will start the weekend of Sept. 29/30, processing applications. Maximus will extend hours.

4.          Commission Workplan for Health Reform Strategy                       Jim Hester                  

a.     Workgroups:

i.       9/6 Discussion drafts for Workgroup 2: Primary prevention of obesity, and Workgroup 5: system capacity

ii.     Mid to late September: workgroups 3: cost control and 4 health information technology

b.     Future Commission meetings: Friday, September 28 (Central Vermont); Tuesday, October 23;  Tuesday, November 20 (Springfield?)

Jim Hester acknowledged Myra Sessions’ contributions, thanked her for her work to date.

Jim gave an update on the status of all the workgroups.  Discussion drafts are being prepared for WG #2 and WG #5. We should set meetings for the Commission/legislative members for the next two weeks.

The next full HCRC meeting: Friday 9/28/07 at Central Vt. Medical Center. Includes a site visit with Blueprint.

The last site visit might be Springfield—possibly Oct. or Nov. HCRC meeting.

The meeting adjourned at 4:00 PM.

Respectfully submitted,

Loring Starr