UVM Health Network reduces frustration, confusion – VTDigger

For 18 years, Patty Croccolo has been a patient at a family medicine clinic in Waitsfield.

The center, affiliated with Central Vermont Medical Center, is 15 minutes from his home in Warren. Her daughter works as a part-time nurse there, and the medical staff is “great,” she said. About a decade ago, when he was diagnosed with colon cancer, Croccolo’s donors at the clinic were fine, he said.

“They got me in here right away, they sent me to the hospital right away. I was diagnosed with this disease before the end of the week,” he said. “They were so supportive — oh my gosh. They helped me get into Boston for care. This office means a lot to me personally.”

Croccolo was one of about 25 people and community donors who braved the freezing rain in Waitsfield Thursday to protest the clinic’s closing. As passing cars honked their horns in support, he and others held up signs and cheered.

He said: “I don’t want to see this place removed.

CVMC Family Medicine Mad River is slated to be the victim of service cuts announced by the University of Vermont Health Network last week.

Those cuts include: closing a psychiatric center at Central Vermont Medical Center, closing two clinics in Waitsfield, downsizing dialysis facilities in Rutland, Newport and St. Albans, eliminating transplant services at UVM Medical Center and reducing the number of patients at the Burlington hospital by about 10%.

Leaders of the health network blamed the Green Mountain Care Board. Recent directives from the health care regulator — orders that limit network revenue growth and reduce the cost of commercial insurance at its Burlington hospital — forced their hand, executives say.

But the health network’s proposed gains have sparked anger and frustration among advocates, health care organizations and members of the public across the country.

“The network’s recent and hasty decision to cut essential medical services for Vermonters — even in the midst of fiscally sound measures with well-placed measures — undermines our ability to plan the way forward. of stabilizing health care costs,” Mike Fisher, Vermont’s health chief. care advocate, wrote in a public letter of 20 Nov.

“Cutting medical services to patients is a last resort for financially challenged hospital networks,” Fisher wrote. “At this point, it seems like a political strategy that is punishing by a profiteer.”

Stephen Leffler, president and chief operating officer of UVM Medical Center, said in an interview Thursday that the hospital network is also frustrated by the situation.

“I don’t blame people for being upset,” Leffler said. “I’m sorry we have to do this. This is not what anyone wants. ”

But, he said, the internet has limited room to maneuver within the realities of health care management.

The Green Mountain Board of Trustees has increased the amount of patient income the network can raise and ordered UVM Medical Center to reduce its commercial insurance premiums by 1%.

Because Medicaid and Medicare reimbursement rates are fixed, Leffler argued, the mandate to reduce patient revenue growth actually means reducing patient care. The network cannot reduce some of the costs of business insurance, he said.

“If we cut our rates, let’s say, minus 5%, then we’re going to have to cut our costs by that amount, right?” Leffler said. “Now you’re talking about taking another 30 million dollars from the costs that will have to come out of patient care. There is no other way for the 30 million dollars, in expenses, to come out. ​​”

Leffler did not provide firm timelines for most of the planned changes, though he did say that UVM Medical Center will reduce its population from 450 beds to 400 beds over the next six months. He said that the first part of the reduction, the closing of about 20 beds, will come in the first week of December.

The network is seeking a halt to the Green Mountain Care Board’s order cutting its commercial insurance premiums — a break that, if granted, would allow it to “reconsider” the cuts, he said.

Some of the cuts will target services that are already lacking across the country. Closing a Waitsfield family medicine clinic, for example, means the facility’s primary care providers will move to Waterbury — meaning, perhaps, a longer drive and reduced access for more patients.

Both locations have waiting lists of 500 or more prospective patients, according to Barry Bolio, an operations support specialist at CVMC Family Medicine in Mad River.

“How can that not destroy the system?” Bolio said in an interview. “If nothing else changes – if we take this clinic and move it to another building – I don’t see what that would do other than put the seats of the Titanic together.”

Desiree de Waal, treasurer of the Vermont Kidney Association, said in an email that the organization was “surprised by the announcement” of changes to UVM Health Network’s transplant center and dialysis services in Rutland, St. Albans and Newport.

“Dialysis patients rely on transportation to dialysis which is scarce and challenging in rural areas,” de Waal wrote. “Dialysis units affected by the announcement are located in Vermont areas with severe transportation needs.”

UVM Health Network said it is in discussions with other hospitals about maintaining dialysis centers.

In Central Vermont, news of the closure of Central Vermont Medical Center’s psychiatric beds sparked “fear and real fear about what’s happening to people,” Rep. Anne Donahue, R-Northfield, said in an interview.

In fact, last year, UVM Health Network told the Green Mountain Care Board that it planned to invest $4.5 million – part of an earlier profit of about $20 million – in the improvement of the unit.

About six years ago, the board ordered the network to invest the remaining money to expand the state’s capacity for mental health patients. Now, plans to shut it down represent a sudden face for the network.

Annie Mackin, spokeswoman for the UVM Health Network, said leaders are committed to using the money to strengthen mental health capacity in Vermont.

The network has invested in “integrating mental health physicians into all of our primary care systems, including CVMC,” Mackin said in an email. “We would like to explore the use of funds again to support emergency mental health services in central Vermont.”

But Donahue, who is on the hospital’s psychiatry advisory committee and has spent time as a psychiatry patient, says the change could put people with mental illness at risk.

“These are people who are at risk for their lives,” Donahue said. “You are not admitted to the hospital because you feel depressed. You’re admitted to intensive care because you’re in immediate danger – if you’re not stable – you’re in danger of dying by suicide or something like that.”