Dear Editor,We commend the Green Mountain Care Board for augmenting its efforts in tackling the crippling health care costs in Vermont, most specifically in relation to the recent FY2025 Hospital Budget Decision And Order, as well as stimulating serious discussions through the presentation of the Oliver Wyman consultant report.The order demonstrates GMCB’s assessment that hospital administrative costs and outsized prices, particularly at the state’s largest hospital, are major drivers of regional expense — ones that Vermonters can no longer afford, and that are severely out-of-step when compared to metrics from peer organizations in other states. Impressive analysis and thought appear to have gone into the GMCB orders. The Oliver Wyman report that grew out of 2022’s Act 167 further informs and raises many specific opportunities for change — aimed at righting the course of care affordability. The calls to support lower cost options for care, to move outpatient procedures out of hospitals and to reduce administrative costs are spot-on. We acknowledge major problems with primary care access, and with much consultant specialist access, as well. These issues need to be addressed through changing an unsupportive, burdensome and dispiriting delivery system that causes inefficiencies, provider “burn-out,” poor productivity and the inability to compete with other states to attract and retain high-quality practitioners.Historically, Vermont has one of the healthiest populations in the U.S. and maintains very low Medicare patient costs, and yet it incurs some of the highest per-capita health care costs in the country. Vermont’s school budgets, workforce recruitment and ability to retain robust thriving businesses are stifled by health care reform failures.Collectively, we have many decades of experience as Vermonters, as patients of Vermont’s hospitals and providers, and as physicians delivering medical and surgical care to Vermonters. We are writing for three reasons:To thank the GMCB for its efforts to respond to Act 167’s mandate and get the conversation moving forward anew, and To encourage those who would criticize the GMCB’s efforts to instead propose alternative meaningful solutions to Vermont’s inoperative health care model, even by giving up some power, control and/or profit for the wellbeing of our neighbors and our communities. To implore legislators, regulators and gubernatorial administration officials to support the GMCB in its efforts to improve Vermont’s health care delivery. There will remain massive pressures to resist, to promote further delay and to abandon what needs to be done. Political courage is needed now more than ever. We ask that everyone work together towards meaningful reform, despite major changes that may be necessary for individual organizations or communities.We appreciate the enormity of the work that the GMCB has been charged with, and we especially thank them for their proactive efforts and dedication. After more than a decade of largely ineffective health care reform, their bold action is crucial. We look forward to working with the GMCB, and trust that other health care providers will join in collaborative efforts towards a common goal for Vermont.Sincerely,Katherine Areson, MD, Maitri Health Care For Women, Chittenden CountyN. Anton Borja, DO, Integrative Osteopathic Family Medicine, Chittenden CountyMelissa Brandes, MD, Green Mountain Internal Medicine, Chittenden CountyJennifer Brown, MD, Northeastern Reproductive Medicine, Chittenden CountyKimberly Bruno, MD, Tamarack Family Medicine, Lamoille CountyEsther Caballero-Manrique, MD, Anesthesia Associates of Vermont, Chittenden CountyPeter Casson, MD, Northeastern Reproductive Medicine, Chittenden CountyArmando Ciampa, MD, Vermont Surgpath, Lamoille CountyMelissa Gibson, MD, Chittenden County,Alex Graham, MD, Chittenden CountyAndrew Haig, MD, Haig Physical Medicine, Addison CountyCory Halliburton, MD, Vermont Gastroenterology, Chittenden CountyChristopher J. Hebert, MD, Green Mountain Internal Medicine, Chittenden CountyAlex John, MD, Vermont Gastroenterology, Chittenden CountyPhilip Kiely, MD, Tamarack Family Medicine, Lamoille CountyAlan Landau, MD, Vermont Gastroenterology, Chittenden CountyKate Lane, MD, Ophthalmic Consultants of Vermont, Chittenden CountyJane Lowell, MD, Maitri Health Care For Women, Chittenden CountySusan MacLennan, MD, Mountain Lake Plastic Surgery, Chittenden CountyGregory McCormick, MD, Ophthalmic Consultants of Vermont, Chittenden CountyScott McQuilkin, DO, Anesthesia Associates of Vermont, Chittenden CountyVincent Miller, MD, Anesthesia Associates of Vermont, Chittenden CountyChristine Murray, MD, Northeastern Reproductive Medicine, Chittenden CountyJoseph Nasca, MD, Georgia Pediatrics, Franklin County Paul Parker, MD, Richmond Pediatric and Adolescent Medicine, Chittenden CountyPaul Reiss, MD, Chittenden CountyDennis Sanders, MD, Champlain Valley Hematology Oncology, Chittenden CountyDavid Schwartz, MD, Vermont Gastroenterology, Chittenden CountyJessica Sisto, MD, Chittenden CountyLindsay Smith, MD, Maitri Health Care For Women, Chittenden CountyPeter Spitellie, MD, Anesthesia Associates of Vermont, Chittenden CountyMary Stanley, MD, Mountain View Breast Care, Chittenden CountyAmy Thibault, MD, Maitri Health Care For Women, Chittenden CountyJulie Thompson, DO, Chittenden CountyAdriane Trout, MD, Thomas Chittenden Health Center, Chittenden CountyMichael Visker, MD, Georgia Pediatrics, Franklin CountyDavid Weissgold, MD, Retina Center of Vermont, Chittenden CountyPeter Wilhelm, MD, Middlebury Family Health, Addison CountyJohn Wright MD, Wright Medicine, Chittenden CountyMichelle Young, MD, Retina Center of Vermont, Chittenden CountyRead the story on VTDigger here: Vermont physicians: We need to support the Green Mountain Care Board in its efforts to improve Vermont’s health care delivery.