[H]ealth care regulators have approved budgets for 14 Vermont hospitals, slightly decreasing the amount they sought to take in from patients and insurance companies.
The Green Mountain Care Board will allow the hospitals to increase patient care revenue by an average of 3.01 percent, and increase prices that patients and insurance companies pay by an average of 2.08 percent.
Those numbers are slight decreases from what the 14 hospitals originally sought: an average patient care revenue increase of 3.6 percent, or $87 million, and average price increases of 2.4 percent.
Patient care revenue is money that hospitals take in from Medicare, Medicaid, commercial insurance companies, and self-pay customers. The revenue does not include other operating revenue, such as money from cafeterias and parking garages.
The majority of hospitals had their budgets approved as submitted. Central Vermont Medical Center trimmed its budget from a 3.5 percent increase in patient care revenue to a 3.39 percent increase in patient care revenue. The board approved the updated budget.
The board also made changes to budgets for Copley Hospital in Morrisville, Brattleboro Memorial Hospital, Northeastern Vermont Regional Hospital in St. Johnsbury, and Northwestern Medical Center in St. Albans.
• The board ordered Copley to reduce average prices by 3.4 percent because members had concerns about revenue from its new surgical center. Revenue is way up from surgeries because of increased utilization, they said.
• The board had told Northwestern in April to reduce its prices by 1.1 percent, but Northwestern requested a 6 percent price increase. The board compromised and allowed Northwestern to increase its prices by 3.5 percent.
• The board reduced Northeastern’s average price increase from 4.25 percent to 3.2 percent. The board had ordered Northeastern in April to limit its price increase to 3.2 percent.
• They reduced Brattleboro’s price increase from an average of 8.9 percent to an average of 5.7 percent. The hospital had originally sought to use its price increase to fund risk it will be taking under the all-payer model.
Additionally, the board ordered the UVM Medical Center to reduce prices for some primary care procedures by $11.3 million in an effort to move toward parity between how much insurers pay the hospital for those services and how much insurers pay independent doctors for those services.
The UVM Medical Center had already proposed to reduce some prices by $11.3 million within its $1.2 billion budget; the board simply instructed them on which procedures they need to decrease prices, according to Susan Barrett, the executive director of the Green Mountain Care Board.
The board also voted to require the UVM Health Network and UVM Medical Center to provide a “funds flow” spreadsheet annually showing how much money they are sending over to affiliated hospitals in New York, according to Kevin Mullin, the chair of the Green Mountain Care Board.
Dr. John Brumsted, the CEO of the UVM Health Network and UVM Medical Center, presented the board with a similar spreadsheet at a recent meeting. The spreadsheet showed that the UVM Medical Center gets more money from New York patients than it gives back to New York hospitals.
Mullin said the board will also require the network to update the board on actual expenses on a semi-annual basis. “Overall funds flowing between Vermont and New York will not exceed net margin funds to Vermont without prior approval of the GMCB,” he said.
Barrett said the flow of funds to New York is part of being a regional hospital. “Dartmouth is also sending money into the state for Mt. Ascutney, so this is a pretty common regional type of care delivery system that happens,” she said.
Mullin said in a press release about the budget decisions: “While this year’s increases continue the trend of historically low growth, I believe there is much still to do to make health care more affordable and accessible for Vermonters, and to continue to improve the quality of care Vermonters receive at our hospitals.”
The board’s written decisions on hospital budgets are due Oct. 1.
