Mt. Ascutney Hospital and Health Center has expanded its affiliation with New Hampshire-based Dartmouth-Hitchcock health system. The move is illustrative of how hospital executives say providers can improve efficiency and care delivery.
The new relationship allows the two providers to “partner financially,” said Mt. Ascutney CEO Kevin Donovan. The community hospital in Windsor will serve as overflow capacity for Dartmouth-Hitchcock Medical Center patients who need less acute specialized care.
Money from Dartmouth-Hitchcock will allow Mt. Ascutney to take more uninsured patients or people covered by government programs, Donovan said, thereby freeing up beds at the academic medical center in Lebanon, New Hampshire, and allowing some patients to receive care closer to home.
The expanded partnership was first announced last January but became official after receiving the approval of both provider groups board of directors earlier this month. Under the agreement, Mt. Ascutney will remain an independent nonprofit.
Mt. Ascutney will also gain access to surgeons that are part of the Dartmouth Hitchcock physicians group through a lease agreement that will allow the smaller hospital to continue general surgery, urology and orthopedics. That’s a boon for Windsor-area patients, because some low-level surgeries cost less at a community hospital than at an academic medical center, Donovan said.
Mt. Ascutney has been without an orthopedic surgeon since last year, because it wasn’t providing enough orthopedic surgeries to make a staff surgeon affordable, he said.
The two health systems will also increase collaboration on back-office administrative tasks and further integrate their information systems.
Mt. Ascutney was already offering outpatient and rehabilitative services for Dartmouth-Hitchcock patients, and this new agreement strengthens their ties.
The CEOs of the two academic medical centers serving Vermont, Dartmouth-Hitchcock Medical Center and Fletcher Allen Health Care, both said in interviews this summer that the region’s health care system could benefit from greater integration.
John Brumsted, CEO of Fletcher Allen, said providers in Vermont should be having “tough conversations” about where to locate services to maximize value.
“Virtually all of the hospitals provide high end orthopedic procedures, and a lot of inpatient surgical procedures that are elective or semi-elective,” he told VTDigger, “One could argue that there could be … a more rational way to provide those services.”
OneCare Vermont, the accountable care organization that includes all the state’s hospitals – plus Dartmouth Hitchcock for some specialty care services – creates an opportunity to work through the “thorny issues” that accompany discussions of consolidation, Brumsted said.
The shared-savings programs OneCare providers have signed up for with the state and federal government reward collaboration because providers take on responsibility for a population’s health, regardless of where they receive services.
Jim Weinstein, CEO of Dartmouth-Hitchcock, said there are examples of provider consolidation hurting consumers, but the Green Mountain Care Board, which has broad regulatory authority over providers in the state, mitigates those risks in Vermont.
Brumsted and Weinstein also oversee the parent health systems of their academic medical centers. Neither network is actively looking to bring more Vermont providers into their fold.
But Fletcher Allen Partners is in conversations about consolidating with hospitals in northern New York, Brumsted said, and Dartmouth-Hitchcock health system continues to expand partnerships in New Hampshire and elsewhere, a spokesman said.
