Hospital Sustainability Requires a Careful Planning Process with Oversight


Hospital Sustainability Requires a Careful Planning Process with Oversight
By Jeff Tieman, President and Chief Executive Officer and Devon Green, Vice President of Government Relations
For the entirety of the legislative session, VAHHS has been engaged in an important health reform discussion. Vermont has long been committed to innovative health reform and has made real progress in this space, often adopting policies other states later replicate. Unfortunately, this is not the case now, as legislators insist on passing a “hospital sustainability” bill that is extremely expensive without offering clear value to Vermonters.
Last week, the Senate Health and Welfare Committee proposed allocating $4.1 million to the Green Mountain Care Board for an engagement process around hospital sustainability. The GMCB said it would use $3 million of this funding for data gathering and analysis, community engagement and technical assistance for transformation. This is a continuation of their consultant-driven work on the type of health care services they believe individual hospitals should provide. 
The GMCB has had numerous and worrisome discussions around cutting hospital units and health care services in rural communities. Their deliberations often fail to acknowledge the need for resources that would be needed for any kind of meaningful transformation. And the regulator’s planning effort could easily lead to health care providers leaving and patients being unable to access care close to home.
The GMCB has testified about having difficult conversations with communities, but it is unclear how the conversations will be structured beyond hiring a consultant and including relevant stakeholders. The bill passed by the House had GMCB coming back with a plan for community engagement that would address workforce and resources needed. The latest version does not have this critical oversight.
It is unfortunate that this legislature is unwilling to bolster our health care workforce without a concrete plan, but is willing to contribute millions of dollars to a vague effort that could endanger our rural health care workforce.
Sustainability is important, and VAHHS has said so early and often. Hospitals are participating in the All-Payer model, our current reform path, and continue their commitment to moving to a value-based system. What we need right now is some predictability and staying on the path we are already on, not a costly new planning effort to move in a whole new direction that could imperil access.