BCBS Vermont President and CEO Beth Roberts has worked all over New England — but her latest role marks her first foray into Vermont. She described the state’s insurance market as “interesting” in a recent interview with Becker’s, laying out the landscape’s unique challenges.
She said other states in the region — big and small — have more access points to healthcare beyond hospitals. In Vermont, “the majority of the healthcare system is driven by the hospitals.”
“There’s just a different cost structure in the hospital environment,” Ms. Roberts said. “That cost structure, as we all know, is more expensive than when you have a cost structure where you have other independent entities.”
BCBS Vermont launched a campaign in recent months addressing academic medical center pricing. While the efforts precede her, Ms. Roberts said she is proud of the team’s consumer awareness efforts.
The campaign’s website said Burlington, Vt.-based University of Vermont Medical Center had the highest costs, as of Oct. 1. But Ms. Roberts said relationships with hospitals do not have to be “antagonistic or difficult,” referencing her talks with University of Vermont Health CEO Stephen Leffler, MD, who also just took the reins at his organization.
“We sort of made a pact pretty early on that we need to be part of the solution, collectively, and we need to partner together to drive change,” she said. “The conversation starts at the negotiation table to get a better financial deal, but underneath that, we create some value components to that negotiation.”
For example, if a health system built out a population health infrastructure, BCBS Vermont should collaborate with that system to avoid duplicative work since “that healthcare dollar is so delicate,” she said. Ms. Roberts called for greater alignment with resource and data sharing, along with patient outreach.
In addition to healthcare costs, Medicare Advantage was another sore spot for BCBS Vermont. This year, the insurer exited the market but continues to offer supplement plans.
“Because of the small volume of patients that were on Medicare Advantage and how, frankly, we couldn’t find an affordable path forward for them, it was a smart exit,” she said.
Ms. Roberts said the challenges of a small, hospital-centric market call for collaboration.
“Small state — you have to do it that way,” she said. “I see no other way but to form, strengthen, partnerships.”
