Dr. Melinda Estes, president of Fletcher Allen Health Care for the last eight years, will leave her post to take over the top executive position at a major mid-western hospital system, according to several sources in the industry.
Estes joined FAHC in October of 2003 and led the Burlington-based system back to health and high ground after William Boettcher, its previous CEO, was convicted of fraud and sentenced to federal prison.
Fletcher Allen did not confirm that Estes has actually decided to leave. Mike Noble, a Fletcher Allen spokesman, said today that Estes was “exploring an opportunity at a major Midwestern health system.” She informed the Board of Trustees of that at their June 14 meeting, he said.
“While we would hate to see her leave,” the statement said, “we recognize that her almost eight-year tenure at Fletcher Allen is very long for a hospital CEO. Should she leave, we would follow an orderly transition process of appointing interim leadership and conducting a national search for a new CEO. Thanks to her strong leadership, Fletcher Allen is on solid ground and well-positioned for the future.”
The loss of Estes comes at a challenging time for FAHC, which is coping with the Shumlin administration’s effort to convert Vermont’s health care system to a single-payer structure. Fletcher Allen, which delivers nearly half the acute medical care in the state, is by far the largest single element in the system.
Fletcher Allen officials had no comment on who might replace Estes as CEO. The most obvious internal candidates to take over the FAHC helm on an interim basis are Dr. John Brumsted, senior vice president and chief medical officer, Dr. Rick Morin, the dean of the University of Vermont College of Medicine, and Sandra Dalton, R.N., who is a vice president and chief nursing officer. FAHC also has a full roster of senior physicians who might shift to a management role.
The need for Fletcher Allen to get its revamped senior management up to game speed quickly is evident on issues such as the question of establishing a joint venture with the Dartmouth Hitchcock system to deliver health care to large cohorts of patients. Discussions on such an initiative between the two dominant health care systems in the region have been underway for several months and are now coming to a head.
The joint venture, in turn, would be an important element the Vermont single-payer campaign, since it would facilitate a shift in the reimbursement structure from fee-for -service to some sort of capitation device in which the providers would take at least some of the risk for hitting cost targets. Cost containment is the single most important element in any health care reform.
Estes, a neurologist, came to Fletcher Allen from the Cleveland Clinic’s Florida branch. She arrived in Burlington in October of 2003 and replaced Ed Colodny, who served as interim president of the system after Fletcher Allen President William Boettcher was convicted in federal court of crimes associated with obtaining state approval of Fletcher Allen’s renaissance project.
