The state’s health care regulator plans to hold a series of 32 virtual meetings over the next four weeks. The goal of the effort is to gather feedback from providers, patients and community members in every region of Vermont on their experiences with the health care system and what it should look like in the future.
If “yawn” is what you are thinking, you should think again.
The scope of the process, run by the Green Mountain Care Board, is directed and funded by 2022 legislation that calls for the development of strategies for “hospital sustainability and transformation,” which could mean proposals for big changes, particularly for hospitals in rural areas with the most precarious budgets. It allocated $1.75 million toward the effort.
The meetings are being held against a backdrop of a swirling storm of challenges to the stability of the health care system statewide.
There is a widespread shortage of health care providers in most specialties, as well as in primary care, behavioral health and long-term residential care. Meanwhile, the majority of Vermont’s 14 hospitals struggle to operate in the black, even though charges for services have increased far faster than the rate of inflation.
A decade of rising private health insurance premiums, driven in part by those increasing hospital-based charges, has led an estimated 40% of Vermonters to choose lower-value plans. The higher deductibles and copayments that come with those plans often lead them to delay seeing a health care provider.
“Health care costs are rising at a rate that is truly unsustainable, and, if we look at the access problems people are having, those are unacceptable,” board Chair Owen Foster said. “So this process is meant to address and come up with solutions for those problems.”
The meetings, organized by hospital-catchment areas (also called health service areas), are intended to gather feedback that will help consultants craft recommendations. The areas are identified by the towns in or near where a hospital is located: Barre (Central Vermont Medical Center), Bennington (Southwestern Vermont Medical Center), Brattleboro (Brattleboro Memorial Hospital), Burlington (University of Vermont Medical Center), Middlebury (Porter Medical Center), Morrisville (Copley Hospital), Newport (North Country Hospital), Randolph (Gifford Medical Center), Rutland (Rutland Regional Medical Center), Springfield (Springfield Hospital), St. Albans (Northwestern Medical Center), St. Johnsbury (Northeastern Vermont Regional Hospital), Townsend (Grace Cottage Hospital) and White River Junction (Mt. Ascutney Hospital and Health Center).
For each, there is one meeting solely for patient-facing health care providers — broadly defined from doctors and nurses, to physical therapists, dentists, pharmacists and emergency medical technicians — scheduled in the evenings between 6:30 and 8:30.
Community members are invited to attend a regional meeting for the area to which they feel most connected. Those meetings are scheduled between 4 and 6 p.m. Specific dates are available at the Green Mountain Care Board website. They can also choose to attend one of four statewide meetings that are scheduled between 9:30 and 11:30 a.m. on Nov. 1, 3, 6 and 8.
Pre-registration is encouraged, but not required. Written public comments are also being accepted. Separate outreach is also being done to specific groups in each region, particularly those representing underrepresented or underserved populations.
Although the recommendations will be hospital-specific, the goal of the meetings is to get input on the entire health care system, according to Bruce Hamory, a longtime health care executive who works for the consulting firm Oliver Wyman, which has been hired to facilitate the process.
“This has to take into account the fact that hospitals do not exist alone and in fact their survival depends on both the availability and effectiveness of pre-hospital services (and) post-hospital services,” Hamory told a meeting of the care board’s primary care advisory group on Wednesday.
Some options previous studies have floated include reducing overnight inpatient beds or, for some hospitals, eliminating them altogether. But it’s also possible that the information gathered will suggest that additional services are needed in a particular region, Foster said.
“It’s not just revamp hospitals to make them smaller. It can be to add services that people need that they are not getting,” he said.
Either way, participation by the public is critically important.
“They’re the ones who are using the system. They’re the ones who are having problems accessing certain services. They’re the ones paying for the system,” Foster said. “We can’t make decisions without including the people that the process is supposed to benefit and support.”
Correction: A previous version of this story misstated the number of virtual meetings and the amount allocated by the legislature to pay for the engagement process.
