Amends the regulatory duties of the Green Mountain Care Board to include engaging in payment and delivery system reform, including developing and maintaining a method for evaluating systemwide performance and quality. Requires insurer participation in multipayer alternative payment models, global hospital budgets, reference-based pricing, site-neutral payments, and other strategies to promote equitable reimbursement. Also requires the office of the attorney general, in collaboration with the green mountain care board, to develop joint legislative proposals for appropriate review and approval of mergers, affiliations, and divestments involving hospitals, clinics, independent practices, long-term care facilities, and other health care providers located in Vermont by the office of the attorney general or the green mountain care board, or both.