Expenditure analysis; health care spending estimate

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§ 9383. Expenditure analysis; health care spending estimate

(a) The Board shall develop annually an expenditure analysis and an estimate of future health care spending covering a period of at least two years. These analyses shall contain data and information as set forth in this section that the Board shall consider and incorporate into its work in furtherance of its statutory duties, including using them as tools in the Board's review of health insurance rates and the budgets of hospitals and accountable care organizations. The analyses shall:

(1) inform the Board's regulatory processes in order to promote improved health outcomes, health care cost containment, quality of care, access to care, and appropriate resource allocation; and

(2) quantify the total amount of money that has been and is estimated to be expended for all health care services provided by health care facilities and providers in Vermont and for health care services provided to residents of this State regardless of the site of service, to the extent data are available.

(b) The expenditure analysis and the estimate of future health care spending shall include breakdowns for broad sectors such as hospital, physician, mental health, home health, and pharmacy and may include estimates for disease prevention and health promotion activities and other social determinants of health. The analyses shall include:

(1) expenditures by commercial health plans, hospital and medical service corporations, and health maintenance organizations regulated by this State; and

(2) expenditures for Medicare, Medicaid, self-insured employers, and other forms of health coverage, to the extent data are available.

(c) Annually on or before January 15, the Board shall submit the expenditure analysis and the estimate of future health care spending to the House Committees on Appropriations, on Health Care, and on Human Services and the Senate Committees on Appropriations, on Health and Welfare, and on Finance. (Added 2017, No. 167 (Adj. Sess.), § 9, eff. May 22, 2018.)


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