[T]he effort to integrate health care services in the state’s most populous area took a step forward last week with the Visiting Nurse Association of Chittenden and Grand Isle Counties deciding to become part of the University of Vermont Health Network.
Leaders of the two organizations hailed the partnership as a continuation of the move toward providing health care in an integrated, more holistic way, instead of the fee-for-service model where providers are paid for each procedure. The partnership also recognizes the need for more care in homes than in hospitals to keep costs down.
Dr. John Brumsted, the CEO of the UVM network and medical center, has said health care operations in the region need to work cooperatively and not compete to better serve patients.
“This partnership perfectly captures Vermont’s approach to health care reform: bringing providers of all types together in new ways to deliver better, more efficient care,” Brumsted said in a statement. “Better coordination between our organizations will enhance the excellent care the VNA is known for and provide patients with a smoother transition back home when they have had a hospital stay.”
VNA President and CEO Judy Peterson agreed: “I’m thrilled the VNA will have a seat at the table, alongside the UVM Health Network’s member hospitals and physician organization, as we work toward our shared vision of a fully integrated, regional health care system.”
In a statement, Peterson added: “Through better integration, we will be able to provide more seamless, personalized, compassionate care while also improving the health of the whole community by reducing unnecessary hospitalizations and controlling costs.”
Brumsted has likened the network members to family around a table working together.
“This really does make a difference,” Peterson said in an interview Monday. “We’re now a family member and not a guest at the table.”
Peterson said the VNA is financially sound but that Medicare reimbursements are always in jeopardy of going down. But she said patient care, not only finances, motivated the move. The VNA lost money on care but was able to make up for that with donations. Peterson said there is greater recognition that home-based care will be critical to keeping people out of the hospital, where care is more expensive.
“It’s like nirvana,” she said of the shift in focus from hospital-based care to home care.
The VNA will retain its own structure and board of directors. Peterson will report to her board and Brumsted. The VNA budget will also need approval by the network board.
Joining the larger group has a financial upside for the VNA, Peterson said.
“We will continue to provide medically necessary services to anyone who needs them, regardless of their ability to pay,” she said. “Joining the UVM Health Network affords us the opportunity to tap into additional resources to continue this mission.”
The partnership, which goes into effect Jan. 1, does not require approval by the Green Mountain Care Board. The deal has been under discussion since 2015, when Peterson said she and Brumsted first talked about linking hospital and home-care services.
The VNA is largely funded through reimbursements from Medicare, Medicaid and commercial insurance. Visiting nurse associations also get money from self-pay patients, the communities they serve, foundations and nonprofits.
The VNA of Chittenden and Grand Isle Counties, a nonprofit, has an annual budget of about $34 million, sees 6,000 patients a year and has 630 employees.
The health network’s flagship hospital, the UVM Medical Center, has an annual budget of $1.3 billion a year from seeing patients. The hospital and its dialysis centers have more than 1 million patient visits a year and 7,800 employees.
Peterson said the partnership brings other advantages to the VNA, including expanded telemonitoring services, increased education opportunities for clinical staff, and better coordination of care among the VNA, hospital and physician offices. She also said her organization will save money through group purchases via the network and that the affiliation will allow the hospitals and VNA to share electronic medical records.
The VNA said it will keep its name for the next 12 to 18 months but will be rebranded with “a new name and brand identity that is aligned with its role in the network.”
