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Early Impacts of VT Act 119: Creating a Minimum Standard for Patient Financial Assistance
Hart, Zach Kobsa, Jessica Millar, Krista Nguyen, Brian Rezapour, David Urie, Patti Zavez, Emma Pasanen, Mark
Hart, Zach
Kobsa, Jessica
Millar, Krista
Nguyen, Brian
Rezapour, David
Urie, Patti
Zavez, Emma
Pasanen, Mark
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Abstract
Background:
Vermont’s Act 119 was signed into law in 2022 and went into effect on July 1st, 2024. It establishes minimum standards for providing financial assistance programs (FAP) at hospitals throughout Vermont. These include hospital financial assistance policies, billing practices, and communication of available assistance to patients. Despite the requirements, questions remain whether Act 119 has improved patients’ access to FAP statewide.
Methods:
This project seeks perspectives on how hospitals implemented Act 119 by interviewing administrators and direct patient assistance staff, reviewing accessibility of FAP summaries, and analyzing hospital financial assistance data.
Results:
Interviews shared common themes of streamlined financial assistance policies across hospitals, barriers for patients to provide the required documentation, and varying degrees of patient outreach. The Flesch-Kincaid Grade Level of the FAP summaries before and after Act 119 at various hospitals went from an average of 15th grade to 9th grade reading level. Lastly, financial assistance data obtained from Vermont hospitals showed that the majority of approved applicants received free care, 44% received reduced care, and over 50% of denials were due to incomplete documentation. Anecdotally, administrators and direct patient assistance staff mentioned an increase in applicants.
Discussion:
Corroborating the results, the early impact of Vermont’s Act 119 has streamlined the financial assistance process and increased awareness of FAP. However, patients struggle to provide the required documentation and remain underinformed about financial assistance despite greater awareness. Overall, Act 119 has standardized FAP policies to confront the costs of medical debt.
Future Directions:
Future directions include quantifying the impact of Act 119 on FAP utilization by tracking FAP applications and decisions, exploring patients’ awareness of, understanding of, and experiences with FAPs, evaluating FAP financial sustainability for hospitals, given funding challenges, and assessing the effectiveness of hospitals' outreach efforts to inform community members most likely to need financial assistance.
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2025
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Adobe PDF, 565.74 KB