Introduced by Representatives Martin of Springfield, Emmons of Springfield, Fisher of Lincoln, Koch of Barre Town and Pugh of S. Burlington
Subject: Health; hospitals; community reports
Statement of purpose: This bill proposes to require the commissioner of banking, insurance, securities, and health care administration to prepare a statewide hospital performance report.
AN ACT RELATING TO STATEWIDE HOSPITAL PERFORMANCE REPORTS
It is hereby enacted by the General Assembly of the State of Vermont:
Sec. 1. 18 V.S.A. § 9402 is amended to read:
§ 9402. DEFINITIONS
As used in this chapter, unless otherwise indicated:
* * *
report” means the hospital report prepared under section 9405a of this title. (4) “Department”
means the department of banking, insurance, securities, and health care
administration. (5)(4) “Division”
means the division of health care administration. (6)(5) “Expenditure
analysis” means the expenditure analysis developed pursuant to section 9406 of
this title. (7)(6) “Health
care facility” means all institutions, whether public or private, proprietary
or nonprofit, which offer diagnosis, treatment, inpatient, or ambulatory
care to two or more unrelated persons, and the buildings in which those
services are offered. The term shall not apply to any facility operated by
religious groups relying solely on spiritual means through prayer or healing,
but includes all institutions included in subdivision 9432(7) of this title,
except health maintenance organizations. (8)(7) “Health
care provider” means a person, partnership or corporation, other than a
facility or institution, licensed or certified or authorized by law to provide
professional health care service in this state to an individual during that
individual’s medical care, treatment, or confinement. (9)(8) “Health
insurer” means any health insurance company, nonprofit hospital and medical
service corporation, managed care organizations, and, to the extent permitted
under federal law, any administrator of an insured,
self-insured, or publicly funded health care benefit plan offered by public and private entities.
maintenance organization” means any person certified to operate a health
maintenance organization by the commissioner pursuant to chapter 139 of Title
8. (11)(10) “Health
resource allocation plan” means the plan developed by the commissioner and
adopted by the governor under section 9405 of this title. (12)(11) “Hospital”
means an acute care hospital licensed under chapter 43 of this title and
falling within one of the following four distinct categories, as defined by the
commissioner by rule:
(A) Category A1: tertiary teaching hospitals.
(B) Category A2: regional medical centers.
(C) Category A3: community hospital systems.
(D) Category A4: critical access hospitals.
(12) “Hospital performance report” means the statewide hospital performance report prepared under section 9405b of this title.
(13) “Managed care organization” means any financing mechanism or system that manages health care delivery for its members or subscribers, including health maintenance organizations and any other similar health care delivery system or organization.
(14) “Public oversight commission” means the commission established in section 9407 of this title.
(15) “Unified health care budget” means the budget established in accordance with section 9406 of this title.
(16) “State health plan” means the plan developed under section 9405 of this title.
Sec. 2. 18 V.S.A. § 9405b is amended to read:
9405b. STATEWIDE HOSPITAL
commissioner, in consultation with representatives from the public oversight
commission, hospitals, and other groups of health care professionals shall adopt
rules establishing a
standard format for community reports statewide
hospital performance report, as well as the contents, which shall include:
(1) measures of quality, including process and outcome measures, that are valid, reliable, and useful, including comparisons to appropriate national benchmarks for high quality and successful outcomes;
(2) measures of patient safety that are valid, reliable, and useful, including comparisons to appropriate industry benchmarks for safety;
the each hospital’s financial health, including comparisons to
appropriate national benchmarks for efficient operation and fiscal health;
summary of the hospital’s budget, including revenue by source and
quantification of cost shifting to private payers; and
that provide valid, reliable, useful, and efficient information for payers and
the public for the comparison of charges for higher volume health care services
; (6) the
hospital’s process for achieving openness, inclusiveness, and meaningful public
participation in its strategic planning and decision-making; (7) the
hospital’s consumer complaint resolution process, including identification of
the hospital officer or employee responsible for its implementation; (8) information
concerning recently completed or ongoing quality improvement and patient safety
projects; (9) a
summary of the community needs assessment, including a description of strategic
initiatives discussed with or derived from the assessment; the one-year and
four-year capital expenditure plans; and the depreciation schedule for existing
facilities; and (10) information
on membership and governing body qualifications, a listing of the current
governing body members, and means of obtaining a schedule of meetings of the
hospital’s governing body, including times scheduled for public participation.
January 1, 2005 June 1, 2006, and annually thereafter,
the board of directors or other governing body of each hospital licensed
under chapter 43 of this title commissioner shall publish its
community report in a uniform format approved by the commissioner, and the
hospital performance report in accordance with the standards and procedures
adopted by rule under this section , and. Each hospital shall
hold one or more public hearings to permit community members to comment on the
report. Notice of meetings shall be by publication, consistent with section
174 of Title 1. Hospitals located outside this state which serve a significant
number of Vermont residents, as determined by the
commissioner, shall be invited to participate in the community hospital
performance report process established by this subsection.
community reports shall be provided to the public oversight commission and the
commissioner. The commissioner shall publish the reports hospital
performance report on a public website and shall develop and include a
format for comparisons of hospitals within the same categories of quality and
financial indicators. The website shall include also a summary of each
hospital’s budget, including revenue by source.
(d) Each hospital shall include on its website the following:
(1) its process for achieving openness, inclusiveness, and meaningful public participation in its strategic planning and decision-making; and
(2) information on membership and governing body qualifications, a listing of the current governing body members and means of obtaining a schedule of meetings of the hospital’s governing body, including times scheduled for pubic participation.
The Vermont General Assembly
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