Access and the cost of health care services in Vermont were front and center Monday as the Green Mountain Care Board finalized growth targets for four of Vermont’s 14 hospitals in fiscal year 2022.
The four hospital budgets in front of the board Monday were a study in contrasts when it came to their financial outlook. Springfield Hospital, a rural facility that just concluded bankruptcy proceedings, has been short on cash and has too few patients coming through its doors.
The University of Vermont Health Network, the largest and most financially secure provider in the state, has the opposite problem. Its three hospitals in Vermont have the backing of a much larger network, but staffing issues have caused significant delays for patients needing to see specialists.
The regulatory Green Mountain Care Board on Monday denied Springfield’s request for a 5.9% increase in net revenues from patients, saying leaders of the 25-bed hospital were too “aspirational” in their budget targets.
The Green Mountain Care Board required Springfield to rework the budget and operations for 2022. Hospital leaders on Monday said the new rate would deplete Springfield’s reserves even further, decreasing cash on hand for operations from 24 days to 11 days. Springfield entered the budget approval process with the lowest hospital cash reserves in the state, CEO Robert Adcock said.
Kevin Mullin, who chairs the Green Mountain Care Board, said he wanted to give the cash-strapped hospital “a fighting chance” but acknowledged the hospital has been struggling for years.
“I would say, if it wasn’t for the pandemic, I think I would be saying that they don’t deserve more than the 3.5% that was in the guidance,” he said.
The board was more lenient with the University of Vermont Health Network’s three Vermont hospitals — UVM Medical Center in Burlington, Central Vermont Medical Center in Berlin and Porter Medical Center in Middlebury — because these facilities had responded to “pent up” service demands from patients.
UVM Medical Center’s request for a 6% growth target was approved, but the board cut the Burlington hospital’s revenues from private insurers from 7% to 6%, reducing the hospital’s net revenue from patients by roughly $5 million.
The network will be required by the board to provide data on how it plans to control costs in the future.
The board took a similar tack with Porter Medical Center, the network’s smallest Vermont hospital, approving the 4.9% increase leaders at the Middlebury facility requested.
Citing missed financial targets, the board decreased Central Vermont Medical Center’s requested growth rate from 6.5% to 4.54%.
The four hospital approvals were the last in this year’s budget review process, which must conclude by Sept. 15.
The board on Wednesday is slated to reconsider Brattleboro Memorial Hospital’s rate and wrap up the process. The rates go into effect Oct. 1, which is the beginning of fiscal year 2022.