[T]he University of Vermont Health Network acquired an independent orthopedic surgery practice in Berlin on Friday, at the same time the Legislature is putting pressure on the network to stop consolidating.
Green Mountain Orthopaedic Surgery is merging into the state’s largest health system to become part of Central Vermont Medical Center Orthopaedics and Sports Medicine. The doctors, Christian Bean and Christopher Meriam, are now employees of the UVM Health Network.
David Turner, the vice president of physician services at Central Vermont Medical Center, said the doctors would join other orthopedic surgeons this summer at a centralized office for musculoskeletal medicine.
Turner said the doctors approached the hospital because they were having trouble running the business. He said they liked the idea of creating “a singular musculoskeletal service line” and the idea “that we weren’t competing for patients in the future.”
The move is the latest in a string of independent practice acquisitions in central Vermont since the UVM Health Network — which also owns the UVM Medical Center in Burlington and two hospitals in upstate New York — acquired Central Vermont Medical Center in Berlin.
Sen. Tim Ashe, D/P-Chittenden, a longtime critic of hospital acquisitions, called the latest in Berlin “part of a trend we’ve been seeing for a number of years now, and it just speaks to the need to rein in, if you will, the price increases that are associated with these transitions.”
“When an independent practice is purchased by the academic medical center, the immediate effect is that both Blue Cross Blue Shield and Medicaid increase the reimbursement provided for services provided at the facility,” Ashe said.
“With Medicaid struggling so much, we could hardly afford to essentially jack up the payments paid out through Medicaid just because the practice has been purchased by the hospital,” he said.
In response to Ashe’s concerns, and just days before the UVM Health Network acquired the practice, the Senate passed Ashe’s bill S.245. The bill would require hospital systems to notify current patients that the acquisition of their independent doctor’s office may require them to pay higher out-of-pocket costs if they use commercial insurance.
The bill also would require Vermont’s Medicaid program, by July 1, to stop paying hospitals more for the same procedures that the independent practice was providing prior to the acquisition. The bill also orders regulators to present a plan on how to equalize the amount of money that private insurers pay to independent practices, community hospitals and the academic medical center.
“We’d prefer not to see our health care system monopolized by a few large entities,” said Sen. Anthony Pollina, P/D-Washington, “and that’s what’s beginning to happen between UVM Medical Center, which already controls Central Vermont Medical Center, and then you have Dartmouth-Hitchcock Medical Center on the other side of the state.”
“You have some really powerful institutions that are gaining more and more power as they take over more and more of the market,” Pollina said, “so I do have concerns about that, but it’s hard to comment on (Green Mountain Orthopaedic Surgery) until we know more about them.”
Cory Gustafson, a lobbyist for Blue Cross Blue Shield of Vermont, a nonprofit organization that has 70 percent of the state’s commercial insurance market, said he could not disclose how much the insurer pays different doctors for individual services because of competitive concerns.
Gustafson said the insurer has one fee schedule for community providers and one for UVM Medical Center, and “there’s definitely a difference.” He said sometimes the reimbursement to UVM Medical Center can be more than twice what community providers make.
Turner, from CVMC, said the current and new patients would benefit from the acquisition because they would now have access to Central Vermont Medical Center’s financial assistance program, pharmaceutical assistance program and community health team.
“(The surgeons) were really concerned that they might not be able to stay in business, and they’re really important to stay in this community,” Turner said. “They’re two surgeons who we would be without if they went out of business.”
