[V]ermont’s second-largest hospital is asking regulators to approve a $21.7 million expansion and renovation project to accommodate growing demand for orthopedic surgery.
Rutland Regional Medical Center has applied for a permit, called a certificate of need or CON, from the Green Mountain Care Board, which regulates hospital revenue, health insurance prices and major capital investments such as this.
The project cost includes $16.1 million for a new medical office building to house the Vermont Orthopedic Clinic. The hospital’s orthopedic surgery program has outgrown its current facility, the hospital says in its CON application.
As part of the project, the hospital wants to spend $1.7 million renovating the current orthopedic building across the street from the hospital’s main campus to accommodate finance and human resources staffers, who currently work in rental space.
An additional $3.2 million would be for renovating the hospital’s loading dock, which was built in 1957, and an adjacent facility for the hospital’s dietary program. The remaining spending on the project is for financing costs and site drainage.
The hospital expects to complete all parts of the project by the end of 2019.
“It’s not to accommodate further growth,” said Tom Huebner, the CEO of Rutland Regional Medical Center. “It’s really to accommodate services that we’re already providing.”
The Vermont Orthopedic Clinic’s building was built to accommodate four providers, Huebner said. The building now has 12 providers, including orthopedic surgeons, nurse practitioners and physician assistants.
Huebner said the hospital’s orthopedic program is now one of the biggest serving the state — the same size as the orthopedic programs at the University of Vermont Medical Center in Burlington and Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire.
“We have particularly excellent clinicians,” Huebner said. “We’re really proud of the services.”
The hospital’s application comes at a time when the Green Mountain Care Board has been scrutinizing statewide growth in orthopedic surgery. Kevin Mullin, the board chair, has questioned whether hospitals are building infrastructure that encourages too many people to get orthopedic surgery.
On Thursday, for the second year in a row, the board pressed Copley Hospital in Morrisville on its growing orthopedics program, which that hospital also says is one of the best in the state. The board told Copley to redo its fiscal year 2018 budget as a result of increasing revenue from orthopedic surgery.
“Orthopedics has grown at every hospital because of the aging of the population,” Huebner said. “As we get older things wear out and we need things like hip replacements, knee replacements and so forth.”
Additionally, he said technology is constantly improving in orthopedics, so people can get new surgeries done to make them more mobile. At the same time more surgeries are being done, patients are able to go home sooner afterward, spending less time as inpatients.
Huebner said it is unlikely the state’s focus on preventive health care will reduce the need for orthopedic surgery, because people need it to remain mobile. He said the places where the state can reduce demand include treatment of chronic diseases, like lung disease, mental health disorders and substance abuse.
“Mobility is actually a great population health strategy,” he said. “If you can keep people on their feet and able to care for themselves, it often prevents other expenses.”
