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Vermont Health Care Reform Aims for More Coverage, Less Expense, and Better Care

Jennifer Fisher Wilson
[+] Article, Author, and Disclosure Information

Potential Financial Conflicts of Interest: None disclosed.

Ann Intern Med. 2008;148(10):797-800. doi:10.7326/0003-4819-148-10-200805200-00022
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For 2 decades, political leaders in Vermont attempted to pass comprehensive health care reform before Governor Jim Douglas (R) finally signed legislation presented by the Democratic-controlled legislature on 25 May 2006. The Health Care Affordability Act (Act 191) integrated the aim of universal access to health insurance with other initiatives centered on comprehensive coordinated care (especially for people with chronic diseases) and payment reform. “I think that it is the most innovative and important reform that any state has ever passed,” said Kenneth E. Thorpe, PhD, professor of health policy and management at Emory University.

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Posted on May 23, 2008
Megan E Castonguay
Vermont Association of Hospitals and Health Systems
Conflict of Interest: None Declared

To the editor:

The Current Clinical Issues: Vermont Health Care Reform Aims for More Coverage, Less Expense, and Better Care by Ms. Jennifer Fisher Wilson, Science Reporter, (Ann. Int. Med. 2008; 148: 797-800) does a nice job of summarizing recent health care reform efforts in Vermont, but inaccurately describes the ownership of hospitals in Vermont. The article states, "...all of the hospitals are owned by one of 2 essentially noncompeting, nonprofit health systems: Dartmouth-Hitchcock Alliance and Fletcher Allen."

While most tertiary care is provided by Fletcher Allen Health Care and Dartmouth Hitchcock Medical Center, they do not own any other hospitals. Vermont has 14 acute care hospitals, each of which is owned and operated independently.

The Dartmouth Hitchcock Alliance is a collaborative group of 11 hospitals and other organizations from NH, VT, and MA that work in partnership on many initiatives. Dartmouth Hitchcock Medical Center manages the Alliance, but the hospitals are all owned independently.

Vermont hospitals have a history of collaboration and cooperation between themselves and with the state. They have worked closely on a number of issues, with the shared vision of a financially sustainable, high quality, health care system accessible and affordable for all Vermonters.

Conflict of Interest:

None declared

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