UVM Health Network announces widespread service reductions – VTDigger

Updated at 5:37 pm

The University of Vermont Health Network announced plans Thursday for a growing series of cuts to health services at its facilities, cuts that could affect how and where patients across Vermont can get medical care. .

The network plans to eliminate the transplant department at UVM Medical Center, close the inpatient psychiatry center at Central Vermont Medical Center, downsize dialysis programs in Newport, Rutland and St. Albans, and closing two clinics in the Mad River Valley.

UVM Medical Center, located in Burlington, also plans to reduce its inpatient population — currently about 450 — by about 50 in the coming months.

Health network leaders blamed the decline on recent orders from the Green Mountain Care Board, the state’s key health care regulator. Those rules limit how much network hospitals can collect from medical services, and how much they can charge commercial insurance for those services.

“Today is a difficult day for our organization and for our leaders,” Sunny Eappen, CEO of UVM Health Network, said at a press conference Thursday morning. “We have to take action with many measures that we don’t want to do. But because of the decisions made by the Green Mountain Care Board, we are forced to do so.”

A complex health care system

Vermont’s aging population — along with labor shortages, high drug costs, a lack of long-term care facilities and other factors — have driven up health care prices around the state.

In an attempt to keep those costs down, the Green Mountain Care Board recently took tough measures with Vermont hospitals, setting strict limits on patient income and commercial insurance premiums.

But the board’s latest orders have caused friction between the governor and UVM Health Network executives, who say they plan to appeal them. In the meantime, however, the network will continue to cut back, executives say.

“Unfortunately we need to take these steps because this is for this fiscal year,” Eappen said Thursday, “so we need to continue as the legal process continues.”

The Green Mountain Care Board said in a statement Thursday that members learned about the network’s plans a day earlier and wanted to better understand why.

Board members are “deeply concerned about the impact of UVMMC’s decisions on patients, its dedicated staff and the broader health care system,” the board said.

Changes across the country

If implemented as planned, changes to the UVM Health Network — which includes UVM Medical Center in Burlington, Vermont Medical Center in Berlin and Porter Medical Center in Middlebury, as well as three New York hospitals – could affect care throughout Vermont.

In Burlington, UVM Medical Center wants to reduce, by about 50, the number of overnight stays, by reducing hospital transfers and removing barriers to admitting patients to lower-level facilities such as nursing homes. It was not clear how that would be achieved.

Burlington Hospital currently does about a dozen kidney transplants a year. Stopping those would send patients to New Hampshire’s Dartmouth Hitchcock Medical Center, UVM Health Network administrators said.

The health network also hopes to transfer dialysis centers to St. Albans, Newport and Rutland to other non-network operators. Those centers serve about 115 patients and lose about $3 million a year, the network said.

UVM Health Network also plans to close its family medicine clinic and rehabilitation clinic, which are affiliated with Central Vermont Medical Center in Waitsfield.

“Those providers and staff will be relocated to existing primary care facilities,” said Anna Tempesta Noonan, Central Vermont Medical Center’s president and chief operating officer. “The closest clinic we have is in Waterbury, which is 12 kilometers away from where we currently work in the Valley.”

Central Vermont Medical Center, which currently has eight patients, would also close. Noonan said the hospital is working to provide lower-level psychiatric care elsewhere in the hospital, with “improved services” in the emergency department and “psychological supports” in primary care centers.

Administrators said they have also implemented or plan to reduce non-clinical costs totaling $38 million, including delays in maintenance and improvements and suspension of programs to improve patient access to care. , according to Thursday’s announcement.

Network executives said the cuts would affect about 200 workers in total. The hospitals plan not to renew the contracts of about 100 mobile workers and to find other positions within the network for about 100 permanent workers.

The changes announced Thursday come just a month after UVM Health Network announced it would delay construction of an outpatient surgery center — another move it blamed on orders from the Green Mountain Care Board.

UVM administrators did not give a hard time for the cuts, saying it would likely take months to implement.

Concerns from stakeholders

In an interview Thursday, Owen Foster, chairman of the Green Mountain Board of Trustees, rejected UVM Health Network executives’ contention that the manager was responsible for the cuts.

“I think the board’s responsibility is to keep costs down and make sure access and quality are adequate,” Foster said. “And what we found out is that UVM didn’t get those signals. They have very high prices, their quality is going down, and their access was limited. So I think in those cases, with those estimates, we made the right decisions.”

Foster said the hospital could have taken many other steps to reduce costs without cutting health care services, such as improving operations, paying off loans from network hospitals of New York and budgeting for state aid accordingly.

“I think there are a lot of other hospitals, some academic medical centers around the country, some hospitals in Vermont, that (have) done a much better job of controlling costs over the last five years,” he said. said Foster.

Thursday’s announcement also drew criticism from the Vermont Federation of Nurses and Health Professionals, which represents about 3,000 nurses and other employees at the University of Vermont Medical Center. Deb Snell, the union’s president, called the news of the cuts “very disappointing” in an interview Thursday.

“UVM Health Network appears not to be taking responsibility for their financial mismanagement over the past several years,” Snell said. And now these decisions are coming on the backs of Vermonters.

Mike Fisher, Vermont’s chief health officer, also expressed concern about the spread of the virus.

“I’m upset at UVM for blaming the economic situation we’re in on the Green Mountain Care Board,” Fisher said. “We desperately need UVM and other hospitals to come to the table in good faith to see how we can best serve Vermonters given the financial challenges we are in.”