Amy Cooper, the executive director of HealthFirst, took aim at the University of Vermont Medical Center’s statements that it has plenty of capacity in its surgery rooms and that hospitals are fully nonprofit entities.
Cooper’s testimony happened in front of the Green Mountain Care Board on Wednesday. The board scheduled the additional time for testimony that Northwestern Medical Center, investors and members of the public were not able to complete last week.
At last week’s hearing, representatives for Northwestern Medical Center in St. Albans and the Vermont Association of Hospitals and Health Systems framed the proposed six-room independent surgical center as a for-profit, “unregulated” project that would hurt community hospitals and drive up health care costs.
“The doctors who were accused of being profit mongers during the hearing last week are the same ones who have been serving this community for many years and have taken all payments, including substandard Medicaid rates, with no ability to cost-shift in their budget for this,” Cooper said Wednesday.
“It is done purely out of a sense of a community,” she said. “I think independent physicians in Vermont have shown historically that they are primarily community-driven, rather than primarily profit-driven. They dedicate the majority of their lives to serve others, and I think a little more consideration of that fact would be appropriate.”
Cooper said recent UVM Medical Center financial reports describe that the hospital has for-profit endeavors. She also cited meeting materials from the Vermont Association of Hospitals and Health Systems that say disruptions can spur innovation.
“The UVM Medical Center, Vermont’s largest nonprofit corporation, notes on page 12 of its 2016 financial report that UVMMC runs some ‘for-profit’ corporations, without offering definitions as to what they do,” Cooper said, making air quotes when she said “for-profit.”
“One is called UVM Medical Center Executive Services,” she said. “Another, 116 Realty. Another is called UVM Health Ventures. Another is called VMCIC, which is exempted from taxes by the government of Bermuda until 2035.”
“They also state, in their financials, that some of these entities are not accounted for in their statements because they have uncertain tax positions,” Cooper added.
She also disputed testimony from Christina Oliver, the vice president of clinical services at the UVM Medical Center, who said last week that the proposed surgical center is not needed because the hospital’s operating rooms and procedure rooms are working far below capacity.
“We have no requests for blocked time (in procedure rooms) and no requests to fill them,” Oliver said last week. “There are no requests from our queue, no complaints from surgeons waiting to get access, and no patients waiting to get access” to operating rooms.
Cooper said the medical center’s intake endoscopy rooms are so full that it creates a bottleneck such that the procedure rooms cannot be used. “Given the realities of this situation, in effect (the utilization rate Oliver referenced) is in fact full capacity at UVMMC,” she said.
“The truth is that there are not enough intake rooms in the endoscopy center to support keeping all of the procedure rooms full at all times,” Cooper said. “That is why there are available hours and empty rooms in their utilization calculations, but that does not mean that they can realistically be used to that capacity.”
She went on to read from an invitation to the annual meeting in September of the Vermont Association of Hospitals and Health Systems, with the theme “Positive disruptions and the opportunities ahead.” She read a Melinda Gates quote from the invitation praising the potential benefits of disruption in solving health challenges.
Cooper concluded by saying, “Our small (surgical center) project is just the kind of positive disruption that is needed in Vermont health care, and it will be a disruption that our hospitals are ready for, are preparing for, and are capable of reacting to, in the best interests of the patients, the payers, and the community at large.”
The hospital association, which did not testify Wednesday, has argued in the past that there is no need for the surgical center; it would increase the cost of commercial health insurance and the need for public funding to Medicaid and Medicare; and it is “inconsistent with health care reform.”
The Green Mountain Care Board will continue to accept public comment through its website until May 1.