Editor’s note: This commentary is by Judy Tartaglia, who is the former president and CEO of Central Vermont Medical Center, a part of UVM Health Network.
[I] want to tell you a story that I hope will set the record straight about an important development in Vermont’s health care system that I know to be a very positive and necessary step to preserve and improve health care services in our communities: the creation of a partnership of nonprofit hospitals called the University of Vermont Health Network.
The story really begins with the passage of the Affordable Care Act (ACA) in 2010. As you’ll see, it’s not a coincidence that the growth of the UVM Health Network, and a record number of hospital consolidations across the nation, started happening when “Obamacare” came about.
That law, and simultaneous reform efforts in Vermont, touched-off the most dramatic shifts in how health care is regulated, paid for and delivered that I’ve seen in my long career, which culminated in being president and CEO of Central Vermont Medical Center until earlier this year.
The more we learned about the changes the Affordable Care Act (aka Obamacare) was going to bring, one thing became clear: Banding together was the best way to manage this unprecedented change in the midst of declining reimbursements, a sluggish economy and other financial pressures.
The risks were real. Seventy rural hospitals in the U.S. have closed since the ACA passed, and 700 more are in jeopardy of failing today. Because Vermont’s health care system requires strong community hospitals, it would have been irresponsible to remain a small boat alone in the coming storm.
But it wasn’t just about being prepared to deal with all of this change. Better coordination was also the only way to accomplish the goals we enthusiastically share with Vermont policymakers to improve access, quality and cost control. During a previous job in Maine, I’d witnessed how harnessing the power of partnership helped achieve these results. Creating networks of hospitals and other providers was also the very basis of a key reform in the ACA known as accountable care, which the state and the University of Vermont Health Network embraced.
All of those factors led me to start a conversation with the UVM Medical Center (then Fletcher Allen Health Care) to explore how to strengthen our relationship. CVMC’s board of trustees — a group of dedicated, civic-minded volunteers — carefully analyzed the change and agreed it was the best course. It was not a difficult decision for either me or the board to make.
I know the strength of the network will be key to Vermont weathering what could be the biggest policy storm yet.
For these reasons and others, community boards at independent hospitals in Vermont and northern New York have since decided to join the UVM Health Network. Just last month, the Visiting Nurses Association of Chittenden and Grand Isle Counties indicated it is interested in joining as well. This would be a great addition, because better coordination of home care is critical to improving health, and health care.
I’m happy to report that the benefits the CVMC board and I anticipated became a reality. Here are just a few examples:
• Greater purchasing power has saved CVMC nearly $2 million — a very big number for a hospital our size.
• Our patients have more access to the expertise and specialty services the UVM Medical Center provides, closer to home.
• Stronger quality improvement programs ultimately earned CVMC a ranking in the top 20 of community hospitals in the nation in the most credible analysis of its kind.
• We’re more successful attracting specialists of the highest quality because practicing academic medicine in a community setting is a desirable situation for many providers.
These are all positive strides that were simply not possible when we were operating independently. Now that we’re colleagues, we can look at the big picture and decide how to use our collective resources to provide high quality, efficient care as close to home as possible.
Because I know these facts, it concerns me when I read or hear assertions that the growth of this voluntary partnership is really about building a profitable business empire instead of doing what is necessary to maintain the services our communities need in the midst of enormous disruptions in health care.
The truth is that coordination of care through the UVM Health Network — compelled and required by state and federal reforms, embraced by its member hospitals as the best way to improve our health care system, and necessary for the stability of community hospitals during turbulent times — has made a very positive impact on health care in the central Vermont region and will continue to do so.
That’s why I believe partnering with the UVM Medical Center was one of the best decisions CVMC’s board and I made, especially because I know the strength of the network will be key to Vermont weathering what could be the biggest policy storm yet.
It has been an honor to lead CVMC. I depart knowing it is in the very capable hands of the new president Anna Noonan, with whom I’ve worked closely on quality improvement projects. I know with her leadership and the close partnerships it has with fellow members of the UVM Health Network, CVMC will continue to be a strong and essential part of the quality of life in our community.
