Parker: Investment helps healthcare crisis

This legislative session was a wake-up call for Vermont lawmakers amid one of the largest healthcare affordability crises facing both the state and the nation. Vermont's healthcare system now totals roughly $2.5 billion and accounts for nearly 30% of the state budget. These costs are directly felt through higher premiums, out-of-pocket expenses and rising overall healthcare costs for Vermonters.

Since 2018, health insurance premiums have increased by 10 to 15% annually, and Vermont Chamber of Commerce highlights that Vermonters spend nearly 20% of their personal income on healthcare — the highest share in the nation. These trends reflect an ongoing crisis in which rising costs and persistent care gaps leave vulnerable patients without access to services and treatments they need.

Addressing these challenges will require greater investment across the healthcare system, which can be provided by responsible private capital. Private investment in healthcare facilities and services can help expand access to care, modernize infrastructure, support new technologies, and improve patient access in underserved communities.

At the same time, oversight and accountability remain essential. In some cases, the actions of a few bad actors have led to financial distress or bankruptcy among healthcare entities, leaving patients without reliable access to critical care. That is why private investment must be paired with appropriate guardrails to ensure patients remain the top priority, and a bill circulating through the Vermont Legislature would do exactly that.

Vermont's H.583, which passed both legislative chambers this session and is now headed to the governor's desk, is a step in the right direction. The legislation seeks to establish guardrails that increase transparency and oversight while still allowing responsible investment to support innovation, expand access to care, and strengthen healthcare delivery across the state. This legislation includes provisions designed to protect the integrity of patient care by prohibiting private equity groups and hedge funds from controlling clinical decision-making and certain operational functions, ensuring doctors and medical professionals — not outside investors — remain responsible for patient care decisions. Additionally, H.583 would strengthen transparency by implementing a clearer reporting system and requiring disclosures about ownership and control of certain healthcare facilities and management organizations. These provisions would give policymakers, regulators and patients a better understanding of who is operating and influencing healthcare entities throughout Vermont and how this impacts the care they receive.

We are already seeing this play out with American Family Care, a private equity-backed urgent care network that has expanded access to convenient, lower-cost, healthcare services across the country, including in parts of New Hampshire and the broader New England region. By investing in urgent care clinics and outpatient facilities, companies like AFC have helped patients access walk-in care closer to home, reducing strain on overcrowded emergency rooms and improving access to routine treatment in communities that may otherwise face provider shortages. Vermont has an opportunity to replicate similar models of responsible investment while still maintaining strong oversight and patient protections, and legislation like H.583 is helping advance these efforts.

The reality is Vermont's healthcare system is under significant financial strain, particularly in rural and underserved communities where providers are struggling to keep services available and facilities operational. Responsible investment, paired with strong oversight and transparency requirements, can help provide financial stability and innovation necessary to preserve and expand access to care.

Patients deserve a healthcare system that is both affordable and accessible. Responsible private investment is helping achieve that goal by modernizing healthcare facilities and supporting essential healthcare workers, ensuring Vermonters can continue to access convenient, quality care. H.583 represented an important opportunity for Vermont to strike that balance by protecting patients while still allowing the investment needed to strengthen healthcare delivery across the state. Policymakers should continue pursuing similar, balanced, patient-focused proposals in the future.

With the right guardrails in place, responsible investors can play an important role in building a stronger and more sustainable healthcare network for the future.

Regan Parker serves as CEO of the Association for Responsible Healthcare Investment, Portland, Oregon.