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Owen Foster, chair of the Green Mountain Care board, speaks during roundtable on health care costs hosted by U.S. Sen. Bernie Sanders, I-Vermont, in Burlington on Friday, May 31, 2024. Photo by Glenn Russell\/VTDigger<\/p>\nOwen Foster, chair of the Green Mountain Care board, speaks during roundtable on health care costs hosted by U.S. Sen. Bernie Sanders, I-Vermont, in Burlington on Friday, May 31, 2024. Photo by Glenn Russell\/VTDigger<\/p>\n
The chair of the regulatory board that decides hospital budgets and health insurance premium increases in Vermont is stepping down at the end of September, Gov. Phil Scott announced Friday.\u00a0<\/p>\n
Scott appointed Owen Foster as the Green Mountain Care Board\u2019s chair in 2022 and reappointed him to serve through September 2030. But Foster has decided to cut that term short, saying he wants to spend more time with his children and focus on other professional pursuits. He intends to remain on the board as one of the four regular members, filling a vacancy created by the departure of board member Jess Holmes, whose term ends this year.<\/p>\n
The decision was \u201centirely mine,\u201d he told VTDigger in an interview. \u201cI have young children. I\u2019m a lawyer. I want a chance to focus on my family and my other professional interests a little bit more too.\u201d<\/p>\n
In a press release posted Friday<\/a>, Scott wrote \u201cI appreciate Owen\u2019s willingness to continue serving the people of Vermont. He\u2019s been an effective leader as we work to make healthcare more affordable for Vermonters, and I believe he\u2019ll continue to be a valuable member of the board in this new role.\u201d<\/p>\n Under Foster\u2019s leadership, the board has taken a tougher stance on reining in hospital budgets and insurance premium increases. He leaves his post as hospitals across the state<\/a> struggle to stay out<\/a> of the red and Vermonters pay some of the highest rates<\/a> in the country for Affordable Care Act marketplace plans.<\/p>\n The Green Mountain Care Board was created in 2011<\/a> as part of Vermont\u2019s effort to create state-funded healthcare for all. It is an independent government regulator tasked with<\/a> approving hospitals\u2019 annual budgets and ACA marketplace plans\u2019 annual rate changes, among other authorities.<\/p>\n The board\u2019s hospital budget review<\/a> for the coming fiscal year begins Aug. 3. Foster intends to remain as chair through the whole budget process, until the end of September. The board is already reviewing next year\u2019s rates<\/a> for the two insurers that sell plans on Vermont\u2019s ACA marketplace \u2014 BlueCross BlueShield of Vermont and MVP. This year, Foster has recused himself from participating in the board\u2019s review of BlueCross BlueShield\u2019s rates, citing personal reasons, though he declined to provide more details<\/a> when the state\u2019s healthcare advocate requested an explanation.<\/p>\n Under Foster\u2019s tenure the board has shifted from being a body that largely rubber-stamped hospitals\u2019 and insurers\u2019 requests to one that put serious pressure on both to reduce expenses.<\/p>\n Mike Fisher, the state\u2019s health care advocate, has watched the evolution of the board since its early days: the original idea to combine the regulatory authority of approving hospital budgets and insurers\u2019 premium increases came from a need to make sure that the costs of hospitals\u2019 healthcare services stayed in-line with the amount of money insurers raise through premiums to pay out those claims.\u00a0\u00a0<\/p>\n \u201cThat hasn\u2019t always happened,\u201d Fisher said. \u201cMore and more in recent years, the board has responsibly aligned both the spending and revenue side.\u201d<\/p>\n He also sees this moment of Foster\u2019s tenure as one of much more urgency, one that the board has met \u201cresponsibly.\u201d<\/p>\n In an interview, Foster said that one of the board\u2019s defining points of progress under his leadership has been a push to move care into less-expensive settings if it does not need to occur in a hospital \u2014 for example, outpatient surgery<\/a>, imaging or lab work.\u00a0<\/p>\n During his tenure, he said, the board has also brought a high level of scrutiny to how much Vermonters are paying for administrative services in healthcare.\u00a0\u00a0<\/p>\n \u201cSince I\u2019ve been here, (the board has) very, very much focused on \u2018let\u2019s stop spending on healthcare administration and let\u2019s start spending on the fundamentals of a good healthcare system,\u2019\u201d he said.\u00a0<\/p>\n When Vermont ran its all-payer model<\/a> of healthcare funding, the care board also regulated the Accountable Care Organization responsible for coordinating those payers and payments.\u00a0\u00a0<\/p>\n In his early days as chair, Foster brought a similar skepticism to the ACO\u2019s budget and its executives\u2019 compensation<\/a> that he has brought to the state\u2019s largest hospital group<\/a> in recent years.<\/p>\n \u201cWhen we cut (the ACO\u2019s) budgets, what we did was we redirected the money from spending on healthcare bureaucracy at an ineffective ACO, and we literally took the dollars and said, \u2018Give this to primary care,\u2019\u201d he said.\u00a0<\/p>\n In the early days of Foster\u2019s tenure, when the state still had the all-payer model, Vermont saw itself as more of a leader in innovative healthcare, even as costs mounted and health outcomes plateaued for many Vermonters, Foster said.<\/p>\n \u201cWhen I started, it was not widely understood or accepted how fragile and distressed our healthcare system was,\u201d he said. \u201cI do think a big part of what the staff and the board has done the last four years has focused on educating the Legislature, (the Agency of Human Services), the governor\u2019s office and the public, that we are in a tough situation, and we need to make changes. And now I think everyone really recognizes that.\u201d\u00a0<\/p>\n