When Michael Costa came aboard as CEO of Randolph’s Gifford Hospital in 2024, he couldn’t help but notice that the hospital’s inpatient beds were relatively empty. Meanwhile, Dartmouth Hitchcock’s and UVM Medical Center’s beds seemed to be overflowing.
“So, we started with a conversation with Dartmouth to say, we’re not part of your network but how do we help?” Costa told a joint gathering of legislators from both the House and Senate’s health care committees on Friday.
Since then, he said that his hospital has managed to coordinate with Dartmouth Health and UVM Health, both large academic medical networks, to guide patients to care in the right place. It’s meant that Gifford has been able to double its inpatient numbers, Costa said.
“Look, the academic medical centers like UVM and Dartmouth, they can take care of some really amazing things, but there are simple things that we can take care of. That’s a win for them, a win for us, and most importantly a win for patients who want to get care close to home,” he said.
That philosophy of broader, cross-hospital collaboration has driven Gifford’s crusade toward cost saving, and it’s one that the rest of the state’s hospitals are hoping to embody as well.
CEOs from a handful of Vermont hospitals joined Costa Friday to give lawmakers a pulse check on where the hospital transformation work that Act 167 set in motion in 2022 now stands.
A common throughline: more interest in sharing resources and doctors across Vermont’s hospitals.
At UVM Health for instance, CEO and President Steve Leffler said the network is exploring how it can have fractional specialists to share with other Vermont hospitals who may not need — or be able to afford— a full-time cardiologist, for instance, but want to be able to provide care in their community. Equipment, too, is something that the UVM hospitals can share with smaller community hospitals.
Northeastern Vermont Regional Hospital is no stranger to collaboration like this, its CEO Sean Tester told legislators. They already share a pharmacy director with nearby North Country Hospital. The two NEK hospitals also collaborate on HR policies and procedures to keep either hospital from “re-inventing the wheel,” Tester said.
Costa, from Gifford, also outlined a promising procedural cost-saving mechanism through a collaborative of other small Northeast hospitals. Together, those hospitals share business insurance, have a health insurance pool for their employees and do group purchasing together. It gives the hospital a lot of the benefits of being part of a big organization, without losing what he likes about its independence, Costa said.
“I coach a lot of baseball,” Costa added in closing remarks to lawmakers. “You can win hitting a lot of home runs. It’s easier to hit singles and not make errors. We’ve been trying to do these little common sense things, and they’ve allowed us to succeed.”
— Olivia Gieger
In the know
“Right now we just have to put our heads down and go,” Jill Mazza Olson, the Medicaid systems director for the Vermont Agency of Human Services, told members of the Joint Fiscal Committee in a whirlwind rundown of where things stand with the $195 million of federal funds made available to Vermont through the Rural Health Transformation Fund.
It’s like building an airplane in midflight, Olson said as she walked lawmakers through the laundry list of projects the proposed budget entails: things like mobile units for dental care, expanding EMTs’ ability to treat people in their homes, or more mental health urgent cares. She noted it’s a document that will frequently evolve as the agency receives more guidance from the Centers for Medicare and Medicaid Services, the federal agency administering the funds.
Olson said that the agency has an internal deadline of trying to identify sub-grantees in the state by Aug. 1. It’s a tall order on a tight timeline. Sleep? “It’s not really a thing for us right now,” Olson said to some laughs.
— Olivia Gieger
On the move
The Senate passed a resolution on Friday saying that the chamber, “based on initial and substantial evidence, unequivocally condemns the extrajudicial killings of Renée Good and Alex Pretti as grave violations of human dignity, civil liberties, and the constitutional protections owed to all persons.” The measure, S.R.21 — which was advanced on a 24-5 roll call vote before getting final approval on a voice vote — also urged Vermont’s congressional delegation to oppose any new federal funding for U.S. Customs and Immigration Enforcement unless the Trump administration commits to “demonstrable, enforceable reform” of the agency’s procedures.
All of the “nay” votes came from within the chamber’s 13-member Republican caucus. Several of those senators said they took issue with the use of the phrase “extrajudicial killing.”
“Any misuse of force should be addressed through established legal and judicial processes. However, this resolution reaches conclusions and assigns responsibilities before these processes are completed,” said Sen. Steve Heffernan, R-Addison.
The Vermont House passed a resolution last month that backed a previous statement by Gov. Phil Scott calling for a “pause” of federal immigration enforcement operations after Pretti’s killing at the hands of federal agents.
— Shaun Robinson
Notable numeral
More than 33,000 school employees and their dependents receive health insurance through the Vermont Education Health Initiative, which provides benefit plans to public school workers and their families, as well as some private school employees and some retired school workers.
The top 1% of claimants — 344 people — account for 25% of VEHI’s total spending, or about $286,000 per person per year, according to data presented by VEHI to the Senate Finance Committee Friday.
While VEHI reported that its “cost stratification trends” are stable, the number of high-cost members — those with more than $100,000 in total cost — has risen significantly. In 2021, there were 355 such members. In 2024, there were 580.
Those 580 members — 1.7% of the total pool — accounted for $121.6 million in costs, a third of the pool’s total costs.
— Ethan Weinstein
‘Who in the world?’
President Donald Trump posted a video, that he has since deleted, on his social media platform Truth Social depicting former President Barack Obama and his wife, Michelle Obama, as apes.
“It’s racist. I mean, it’s really raising questions about his competence,” said U.S. Sen. Peter Welch, D-Vt., in the Statehouse Friday.
“Who in the world, as the leader of a country, any country, of the United States of America, would post a video that is so racist?” Welch said.
— Charlotte Oliver
Department of corrections
Yesterday’s newsletter inaccurately described amendments to H.626.
