by Mike Del Trecco, CEO, VAHHS 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.
There is 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 New technologies are brought online, new services replace outdated ones.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’s 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.
Vermont Association of Hospitals and Health Systems