Message From the CEO

For our hospitals, the core mission is simple: preserving and increasing equitable access to quality care in rural Vermont. Meeting this mission is the tricky part. We are attending to older and sicker patients with fewer resources to meet the demands for health care services. This is the time for creativity and teamwork.

To succeed at meeting this mission, our hospitals need a robust and ready workforce along with effective community providers including long-term care, skilled nursing, mental health and more. It is no more complicated than that. If we fall short of this, there is no bill or payment model that will magically solve the challenges we are all attempting to make progress on. From building our budgets to building new partnerships, everything we do as a hospital system, one that is fully non-profit, focuses on how we get closer and closer to meeting our core mission.

Whether it’s a neighbor with cancer, a partner with a chronic disease or a friend who works as a provider, we all have our unique set of experiences that inform our perspectives. Health care is a deeply personal issue even when we’re talking about things like policy and process. That is why, in all we do, I ask myself how our work will impact our patients, providers and communities.

You’ll read in this week’s VAHHS Update at least one story on health care legislation being considered this session. The process laid out for gathering information to inform legislation is one that clearly values a wide variety of agendas and perspectives and seeks to meet the needs of many stakeholders in the health care space. To say this is a tall order for our elected officials is an understatement but I know our lawmakers and state officials are thoughtful, and their intentions are to make the process better in service to Vermonters.

The issue of health care regulation – how hospitals and insurance company oversight should work – is front and center this session and has been the topic of recent media reports. Hospitals are a major part of that oversight, and we accept the regulatory review, respect the difficult job our regulators have, understand the benefits and appreciate the need going forward.

We seek a process that is consistent and predictable. That means it follows a consistent

evaluation process that is well understood and vetted and used from one year to the next. A natural tension between the regulated and the regulator is healthy and necessary in regulatory oversight, but today there exists a thread of unhealthy tension. Part of the increased tension is because the majority, in fact 9 of our 14 hospitals, are operating at a loss—meaning we have slim resources to invest in our people and communities. Weak hospitals jeopardize the vitality of all our communities and imperil our ability to meet the mission described above, and that is why we are so deeply concerned.

You might be asking yourself why this situation matters and how this really impacts those

patients, people and communities I mentioned above. Well, it matters a lot because the impact of this unhealthy tension can be felt throughout the health care system and it’s getting in the way of our ability to meet our core mission. From how hospitals approach protecting and even growing services, hiring physicians and nurses and whether or not hospitals risk investing in outdated facilities, purchasing new and modern equipment and everything else that goes into running a 24/7/365 health care operation.

Very importantly, it also significantly impacts how our hospitals think about health care reform, which is necessary if we are ever to get to a place where we have more value-based care.

So, as the legislative process continues to unfold and the regulatory pieces are considered, we will keep centering the needs of our patients, providers and communities. This is about meeting that core mission and we have little margin for error both literally, and figuratively.

Thanks for reading and have a great week.