Vermont resident: Board should consider how independent practices, competition impact the healthcare system

Gerry Silverstein, a Vermont resident and educator with an interest in health, penned an article in VT Digger citing recent literature showing how independent practices and competition strengthen the healthcare system.

The article pertains to Green Mountain Care Board's decision on whether to approve Green Mountain Surgery Center, a proposal starkly opposed by the Vermont Association of Hospitals and Health Systems. The hospital association says the independent ASC in Colchester, Va., would be unregulated and therefore could not provide the highest quality care at a reduced cost.

Mr. Silverstein cited an article JAMA published in April titled "Making Healthcare Markets Work — Competition Policy for Health Care." The study authors say despite competition improving patient choice, bolstering quality of care and lowering costs, there is a dearth of actionable policy recommendations despite ones that the Federal Trade Commission issued.  

Independent practices also may improve quality and generate major savings. In a 2016 Wall Street Journal article, Bob Kocher, MD, a former adviser to the Obama administration on healthcare policy, said "Over the past five years, published research … has indicated that savings and quality improvement are generated much more often by independent primary-care doctors than by large hospital-centric health systems."

Additionally, JAMA published a 2016 study finding primary care group-led ACOs had more savings than ACOs associated with hospitals.

Based on the wealth of research affirming the benefits on independent practice, Mr. Silverstein said officials should assess the literature and see if the proposal for the independent ASC would benefit the region.

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