[I]ndependent doctors have started an organization in Vermont dedicated to helping them keep their small practices in the face of what they consider pressure to sell out to hospitals.
Doctors have created a Vermont chapter of the Association of Independent Doctors, a national nonprofit organization started in Florida in 2013 that says, “We fight a fight that doctors have neither the time, means, nor clout to pursue.”
The Vermont chapter will have 15 members, who are all current or former board members of HealthFirst, the nonprofit organization that represents the interests of independent doctors at the state level.
Independent doctors are self-employed and own their own practices, as opposed to working in a hospital or for a practice that a hospital or hospital system owns. Insurance companies often pay independent doctors less money than hospital-employed doctors for performing the same procedures.
The Vermont Legislature has passed three laws since 2014 seeking to have the Green Mountain Care Board, which regulates health insurance prices, force insurers to pay independent and hospital-employed doctors equitably. Some legislators say those laws have not led to meaningful progress to protect independent doctors.
“Nationwide, large hospital systems have been aggressively buying up independent doctors and turning them into employed physicians,” Marni Jameson Carey, the executive director of the national Association of Independent Doctors, said in a news release.
“When hospital systems buy private medical practices, costs skyrocket and quality suffers,” Carey said. “As the number of independent doctors shrinks, unfavorable market dynamics, including higher health care costs and lower quality of care, grow. AID is working to reverse that trend, which is not good for patients, doctors or communities.”
“Our concern is really with the growth of large, corporate networks that change the type of care that’s delivered to patients,” Cooper said. “I actually think that small community hospitals and independent doctors have a lot in common.”
Cooper said the new group “really helps connect us with the independent doctors across the country who are dealing with the same sorts of issues, and it really helps us get our message out more nationally about the value of independent practices.”
The only large hospital system based in Vermont is the University of Vermont Health Network, which started in 2011 as an umbrella organization for the UVM Medical Center and Central Vermont Medical Center in Berlin. The network now includes three Vermont hospitals and three hospitals in upstate New York.
Central Vermont Medical Center told the Green Mountain Care Board in March that the number of outpatient practices the network owns in the region has grown by 10 to 15 practices in just three to five years. Regulators have begun questioning whether the expansion will lower expenses in the health care system.
“The only practices that we have acquired have been those that came to us and requested that we brought them inside of the network, and it’s because they couldn’t maybe go the practice on their own, and so to preserve access for those communities, we have hired those physicians and brought them into our practice group,” Brumsted said.
“We have no approach where we go out and try and make a pitch and sell to a practice that they should come inside, and actually I’m unaware of any hospitals in Vermont that do that,” Brumsted said. “It may be a national phenomenon, but I do not believe that that’s anything happening in Vermont.”
In southern Vermont, the New Hampshire-based Dartmouth-Hitchcock Medical Center controls Mount Ascutney Hospital and Health System in Windsor. It has also been strengthening its relationship with Southwestern Vermont Medical Center in Bennington and created a “strategic partnership” with Brattleboro Memorial Hospital.
