Leffler: Academic medicine is essential to care in our state

by Dr Stephen Leffler, President and Chief Operating Officer, UVM Medical Center Vermont’s largest insurer, Blue Cross Blue Shield (BCBSVT), recently submitted a letter to the Green Mountain Care Board questioning the value of The University of Vermont Medical Center (UVMMC), Vermont’s only academic medical center. BCBSVT said that the care we provide has too many “bells and whistles.”

I am not aware of many “bells and whistles” we provide at UVMMC. We try to provide good food to patients and their families, and adequate parking and a clean facility. But mostly we are focused on excellent patient care that patients need, often to save their lives. I understand that our insurers can be far removed from the health care setting, and so the inherent value of high quality, close-to-home care might be lost on them.

If they joined me in this past week on my weekly rounds, health insurance executives would have seen incredible, complex and comprehensive care being delivered at UVMMC. They would have seen parents on our Pediatric floor anxiously waiting as their child received live saving cancer care available nowhere else in the state. Maybe they would have met a patient who just received a Transcatheter Aortic Valve Replacement, a complex non-invasive heart surgery – our hospital is the only one in the state to provide this procedure. They may also have seen a trauma patient whose life saving care depended on Vermont’s only level 1 trauma center.

UVMMC is the only hospital in Vermont where many lifesaving procedures are performed. To these patients, the care we provide isn’t “bells and whistles,” it is life and death.

On my weekly rounds, I also run into medical students, residents and nursing students and many others learning and training in our academic medical center. We have a shortage of clinicians and health care providers in the U.S. – Vermont included. UVMMC provides a learning environment for our future health care providers. Once they graduate, some of them remain in state to contribute to our health care system. Last year 28 physicians stayed in Vermont to practice after completing their training. Recently, we hired 150 nurses, many who graduated from UVM’s nursing program. These home-grown health care providers receive excellent training here, and are our best bet for overcoming the workforce shortage that plagues all of American health care right now.

The University of Vermont Medical Center regularly is recognized as an excellent place to receive care. For the second year in a row we were awarded 5 stars from the Centers for Medicare and Medicaid Services (CMS). Only 15% of hospitals in the US receive 5 stars. This ranking takes into account many factors such as patient experience, outcomes and cost – in short, value.

In terms of cost, CMS says that benchmark procedures at UVMMC cost the same or less than the national average. Our Medicare spending per beneficiary is less than both Vermont and national averages. In fact, we’re the lowest cost academic medical center for Medicare in the country.

These high ratings help us to attract and retain world-class physicians, nurses and other clinicians.

Without an academic medical center, Vermont would be sending patients out of state for many specialized treatments and procedures, further compounding our already existing challenges for access to timely care. Besides the inherent risks, inconvenience (and sometimes impossibility) of travel for a patient and their family members, it would also cost our state. Costs often are higher at out-of-state academic medical centers.

I’m proud of The University of Vermont Medical Center. I am proud of the nearly 8,000 people who work here, all with the singular mission of providing exceptional care to their neighbors, friends and families. We have an amazing team of highly trained and dedicated people here to serve Vermonters. Our academic medical center is a key component to the health system in Vermont. The work we do may seem like “bells and whistles” to an insurance provider, but for the patients who need us and the teams who deliver the care, these aren’t frills, but care that is needed and expertly delivered. Vermont’s academic medical center must remain strong, current and viable so it is ready when we, or our loved ones, need it.