Vermont Legal Aid - Office of the Health Care Advocate - Quarterly Report April 1, 2016 - June 30, 2016

Sep 19, 2026

Quarterly report from the Vermont Legal Aid Office of the Health Care Advocate to the Agency of Administration, covering April 1, 2016 through June 30, 2016. Summarizes hotline call trends, including reductions in overall volume and Vermont Health Connect calls, key call drivers such as billing/premium processing, tax Form 1095-A issues, and Medicaid review questions. Includes case outcomes and dispositions for closed matters, consumer protection initiatives (rate reviews, certificates of need, and ACA-related work), administrative advocacy, litigation, legislative activities, and outreach/education with website analytics and presentations.

LanguageEnglish

CategoryGeneral

FormatPDF

Pages27

Reading Time9 min

AccessFree to download

Introduction

Highlights

Individual Consumer Assistance

Overview

Top Problem Areas

Recommendations

Case Results

Dispositions of Closed Cases

Case Examples

Consumer Protection Activities

Rate Reviews

Certificates of Need

All-Payer Model

Affordable Care Act Tax-Related Activities

Litigation

Administrative Advocacy

Legislative Activities

Collaboration with Other Organizations

Outreach and Education

Website and Google Analytics

PDF Downloads

Education and Presentations

Vermont Legal Aid Office of the Health Care Advocate Quarterly Report April 1, 2016 – June 30, 2016 to the Agency of Administration submitted by Trinka Kerr, Chief Health Care Advocate July 19, 2016 Table of Contents Introduction 1 Highlights 1 Individual Consumer Assistance 3 Overview 3 Top Problem Areas 4 The HCA’s overall call volume was 26% lower than last quarter, very close to the volume during the same quarter last year, and 38% higher than pre-VHC volume. 4 Vermont Health Connect call volume dropped 31% from last quarter and was similar to the call volume during the same quarter last year. 4 Vermont Health Connect change of circumstance calls decreased by 39% from last quarter, and were 58% lower than last fiscal year’s fourth quarter. 5 Vermont Health Connect invoice and billing problems decreased 43% from the previous quarter’s all-time high, but were the second most common reason people called the HCA. 6 Calls about tax Form 1095-A issues increased over the same quarter last year. 6 We received 26 calls related to Medicaid reviews. 7 The top issues generating calls. 7 All Calls 994 (compared to 1,338 last quarter) 7 Vermont Health Connect Calls 505 (compared to 737 last quarter) 7 DVHA Beneficiary Calls 234 (compared to 354 last quarter) 8 Commercial Plan Beneficiary Calls 292 (compared to 437 last quarter) 8 Hotline Call Volume by Type of Insurance: 8 Recommendations 9 Case Results 9 Dispositions of Closed Cases 9 All Calls 9 DVHA Beneficiary Calls 10 Commercial Plan Beneficiary Calls 10 All Calls Case Outcomes 10 Case Examples 11 Consumer Protection Activities 12 Rate Reviews 12 Certificates of Need 13 Other Green Mountain Care Board Activities 13 All-Payer Model 14 Vermont Health Care Innovation Project (SIM Grant) 14 Affordable Care Act Tax-Related Activities 14 Other Activities 15 Litigation 15 Administrative Advocacy 16 Legislative Activities 18 Collaboration with Other Organizations 19 Outreach and Education 20 Website 20 Google Analytics Statistics 20 PDF Downloads 21 Education 22 Education/Outreach 22 Presentations 22 Promoting Plain Language in Health Communications 23 Introduction The Office of the Health Care Advocate (HCA) provides consumer assistance to individual Vermonters on questions and problems related to health insurance and health care. We also engage in a wide variety of consumer protection activities on behalf of the public, including before the Green Mountain Care Board, other state agencies and the state legislature. The full quarterly report for April 1, 2016 – June 30, 2016 includes: 􀁸 This narrative, which contains sections on Individual Consumer Assistance, Consumer Protection Activities and Outreach and Education 􀁸 Seven data reports, including three based on the caller’s insurance status: o All calls/all coverages: 994 calls (compared to 1,338 last quarter) o Department of Vermont Health Access (DVHA) beneficiaries: 234 calls or 24% of total calls (compared to 354 and 26% last quarter) o Commercial plan beneficiaries: 292 calls or 29%(437 and 33%) o Uninsured Vermonters: 108 calls or 11%(149 and 11%) o Vermont Health Connect (VHC): 505 calls or 51%(737 and 55%; the VHC data report draws from the All Calls data set) o Two Reportable Activities (Summary & Detail): 174 activities, 49 documents (225 and 47) Highlights 􀂏 Total hotline call volume decreased 26% from last quarter and was similar to the same quarter in 2015. (The third quarter of the state fiscal year, January – March, typically has the highest call volume of the year.) 􀂏 Vermont Health Connect (VHC) calls were down 31% from last quarter, and very close to the level for the same period last year. 􀂏 Although VHC continues to improve functionality and performance, many Vermonters are still having serious problems. About half of all calls involved VHC, and about hal

FAQs

What period does the quarterly report cover and who submitted it?

The report covers April 1, 2016 through June 30, 2016 and was submitted by Trinka Kerr, Chief Health Care Advocate, dated July 19, 2016.

How did hotline call volume change compared with the previous quarter?

Total hotline call volume decreased 26% from the previous quarter and stayed similar to the same quarter in 2015.

Which issues were most common for calls to the Office of the Health Care Advocate?

Vermont Health Connect invoice and billing problems were a leading reason for calls, along with tax-related Form 1095-A issues and questions related to Medicaid reviews.

Sep 19, 2026

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