Message From the CEO

As I have mentioned on more than one occasion, here in this column and through my public comment to the GMCB, Vermont’s non-profit hospitals evaluate policies and ideas through the lens of the following principles: equitable access to high-quality care; stabilization for hospitals; promotion of a strong care ecosystem outside the hospital, and predictability.

We do this to ensure that positions we take always center our patients and promote vibrant communities. We also do this to protect against decisions that are politically or socially motivated and offer only short-term return with long-term consequences.

You’ll see this week a story or two about a new report being issued about Vermont’s

health care system. You may recall that the legislature passed a bill in 2022 called Act

167 that called for this report which you will hear more about in the coming weeks.

Lawmakers stated purpose was to analyze our health care system for areas that require

investment or change all with an eye towards stabilization to protect care for patients.

We could not be more aligned on this.

Of course, it’s not that simple and there are dire implications for how findings and

recommendations are determined and then shared out with all of you.

Over the past decade, our hospitals have already been doing this work to evolve and

change in a dynamic and challenged environment. Hospitals are evolving to meet our

patient’s changing and growing needs with a focus on keeping costs down and finding

efficiencies where we can, whether it’s workforce, housing, transportation, aging

demographics or new technologies, this work is done in alongside our community

partners.

Our hospitals are places where innovation and change are embraced. That’s a good

thing. New technologies are brought online, new services replace outdated ones. We’ve

retrofitted spaces like our emergency departments to address changing needs of our

communities. We’ve entered into purchasing groups with others to reduce supply chain

costs. We share physicians among other hospitals and community partners to keep

care local and to keep costs down. And our hospitals continue to evolve, it is important

to acknowledge that. With an eye on affordability, we embraced value-based care and

were early adopters. We now have eight 25-bed critical access hospitals; many were

once 100-bed facilities. Well over 50% of our care is delivered on an outpatient basis

where costs are lower. We have reduced growth rates from pre-GMCB levels of 8-9%

annually to approximately 4.5% even as inflation and other factors have increased

costs, we’re keeping them down. This alone is hundreds of millions of dollars of savings.

Unfortunately, even given this good work, there are forces working against the health

care system, putting increased pressure on the delivery system. Because of our older

demographic, we have higher demand and sicker patients and we have become a place

of last resort for care. This drives up costs for everyone. Additionally, there are massive

costs we cannot control like pharmaceuticals.

When you put all of this together, you can see clearly why health care providers and

leaders know better than anyone that the status quo is not acceptable, change is

constant and inevitable.

But it’s not about change itself. It about what the change will do to our communities. No

matter what, we cannot accept recommendations that reduce care for our patients,

especially those in rural communities. We will not support recommendations that harm

our patients, take away critically needed services or cause provider and staff flight as a

result of increased instability. Recall, this work was about stabilizing health care, not

causing further uncertainty and strain. I recognize this is a hard line, but it's essential

that we take this position on behalf of our workforce and patients. Proposals that drive

or create a second-tier delivery system and potentially create patient safety issues and

reduced access should be non-starters and we’ll need your support to hold the line on

this.

If we stay true to the principles above and we all agree to put patients first, we can meet

the moment. Your hospitals pledge to continue evolving to do better by our patients as

efficiently and affordably as possible. You all deserve no less.

Thanks for reading and have a great week.