Other than some added connectivity are they adding better quality vrms, better heatsinks, power delivery? Why would I want to use a z390 over a z370 for say a i9 9900k? Was there some sort of issue with the vrms on z370? My current motherboard is an Asus z370 Maximus X Hero.
No issues. The z370 boards were launched a little earlier than Intel wanted to, they were kind of bridge in a sense. The z370 didn't really have any big issues (outside of the usual launch bugs and quirks). Now the X299 chipset was the one that had some VRM and heatsink design concerns when it first launched.
As far as the heatsinks and VRM, that depends on the build quality of the board, and would be no different than someone buying an entry level motherboard, versus buying a mid-range, or high-end board. Your current board is a high-end board, so not much to worry about there.
Here is what is known about the z370 vs the z390:
https://www.anandtech.com/show/13135/more-details-on-intels-z390-chipset-exposed
For me personally, I would use your current motherboard with the new CPU as there's really not much gained. But on the same token, I have known how strong the lure of the latest and greatest is.