‘Let’s see what sticks.’ That’s the phrase that came to mind when I read Bill Schubart’s most recent opinion piece. He took incorrect information and poorly conceived ideas and wove them into a pointed attack on the UVM Health Network, without advancing the discussion about the real and complex problems facing patients and providers in our region. That is disappointing.
I generally would not respond to individual commentaries such as Mr. Schubart’s, but it included so many misguided assertions that I need to correct the most egregious errors for the record.
Among them:
- The UVM Health Network has pulled out of a planned adolescent psychiatric facility. False. We bid on a Vermont state contract for such a facility, but no contract was awarded. Unfortunately, a VTDigger article also perpetuated this incorrect narrative. Better mental health care is needed in Vermont, especially for children, and we look forward to continued discussions with the state about the role we could play moving forward, while recognizing our current financial state.
- UVM Health Network halted work on an adult psychiatric facility because the Green Mountain Care Board denied us a budget increase. False. UVM Health Network put the project on hold after reviewing our current financial status.
For years, we have not been allowed by the care board to take in revenue that keeps up with the cost of providing care. Then we incurred extraordinary costs to maintain services during the pandemic. Now we are seeing unprecedented cost inflation and a national workforce shortage.
It’s for these reasons alone that we asked for a midyear adjustment.
The facility is needed — we see it every day in our emergency departments, where patients in mental health crisis wait for treatment. We put years of work into gathering input from patients, families and mental health experts and designing a facility. But the reality is that it would cost more than $100 million to build, and lose another $20 million-plus every year because of the discrepancy between the cost of care and reimbursement. Despite the dire need, the combined impact of these factors is that we cannot afford to invest in the psychiatric facility at this time. - UVM Health Network is concerned only with expansion. False. The network was formed to preserve health care in our region and to maintain a high-quality, efficient and financially sustainable system. The last organization to join the network was UVMHN Home Health & Hospice in 2018. We have no plans to affiliate with new organizations or acquire new practices.
- UVM Health Network has abandoned its mission of population health improvement. False. This is why we exist. While rural hospitals across the country struggle and, in many cases, close, we continue to strengthen our network to serve the needs of this region. This includes recently completing installation of a network-wide electronic health record, allowing us to manage provider availability and patient needs centrally, reducing inefficiencies and wait times. We also continue to move ahead with transformative work in primary care and payment reform to improve community health.
- UVM Health Network has become an insurer, doing business in the Medicare Advantage market. False. We have entered into a partnership with MVP (a local, not-for-profit health insurer) to provide a Medicare Advantage product to eligible people in our region that is informed by our doctors. We are part of MVP’s network of health care providers.
- The UVM Medical Center board of directors used to include an open session for public comment and that has been shut down. False. The UVM Medical Center board, which Mr. Schubart used to chair, has had a public input portion of its agenda for decades, and still does.
- UVM Medical Center is among the highest-cost academic medical centers in the country. Misleading at best. Mr. Schubart cites a sadly incomplete data source for this assertion. While it is admittedly difficult to find more complete data for total health care cost comparisons, the Dartmouth Atlas, considered a gold standard, finds us to be among the lowest-cost providers in the country.
Here’s what is true:
As many hospitals across the country cut services to meet their bottom line, the UVM Health Network has done everything we can to maintain the care our patients expect and deserve to receive locally. We continue to do this while navigating the challenges outlined above.
But despite our strength as a network, we cannot and will never be all things to all people. Nor do we have the resources to solve all of the problems faced by the people of our region. Unfortunately, our current financial situation, as we tap into our reserves, is making that fact more evident than ever before.
We are working hard to preserve access to health care in the face of a growing and aging population, while striving to be an innovative academic health system with high-quality care and modern facilities that we can all be proud of. Like any organization with a budget, we must make tough, yet realistic decisions if we want to survive. Our network trustees and leadership will continue to make those decisions based on doing the right thing for our patients, our people, and our communities.