Hospital Budget Hearings Recap

Over the past two weeks, each of our non-profit hospitals presented its budget to the Green Mountain Care Board (GMCB) in a first-of-its-kind virtual hearing process. I want to thank Board members and staff for their time and attention. I also want to applaud our hospital leaders who, in a time of so much uncertainty, presented carefully planned and thoughtfully delivered “recovery budgets.”

The most common element of this year’s hospital budgets was our response—both as individual hospitals and collectively as a system of providers—to COVID-19. The disruption in health care was significant and the impact to clinical, financial and operational systems was massive. The shared story of how hospitals stepped up, became partners with state leaders and executed on the single-most effective response in our country to date is the great news in all of this. The not-so-great news is the effect it continues to have on our organizations. Uncertainty about the challenges we could face is real and persistent; we cannot allow our strong response to cause complacency. Our task now is to preserve Vermont’s gains, prepare for a next wave and ensure we are always ready for public health crises or other disasters.

Delivering health care in our rural and aging state is challenging always but our hospitals are creative problem-solvers. If there is a silver-lining from COVID-19 for clinical health care, it must be the major and likely lasting increased use of telemedicine. Providers and patients have long seen the value in telemedicine but struggled to overcome various perceived obstacles to adoption. Yet hospitals sprang into action during COVID-19 to expand telehealth access—both to minimize the spread of infection and to keep hospital capacity available for a potential surge of COVID patients. Now virtual medical consultations are far more common, and even more advanced than a few months ago. Increased use of telemedicine will continue to benefit our rural state by expanding access and reducing cost.

Despite all the unforeseen challenges of this year, hospitals remain committed to value-based care and the promise of health care reform. Even in the midst of COVID-19 work, our hospitals continue the transition to a system focused on wellness to improve our overall health and, ultimately, slow cost growth. To make this shift, our hospitals assume significant financial risk because population health is so important.

Unlike almost every other place in the country, our hospitals—every one of them—are non-profit. That means they exist entirely to serve their communities. They work together and share providers to keep services local, make major investments in the community and employ thousands of people.  This year’s hospital budgets reflect what these vital organizations need to recover, stabilize and prepare.

We urge the GMCB to accept the budgets presented to them this year and join in supporting our hospitals as they address a global pandemic, work to achieve value-based care and continue to provide high-quality, affordable care in Vermont. 

Jeff Tieman, VAHHS President and CEO