Last month, the University of Vermont Health Network announced a list extensive reductions at its Vermont facilities.
These reductions – which led to a rapid and furious outcry – included the closure of an inpatient psychiatric unit at Central Vermont Medical Center, the end of kidney transplants at the University of Vermont Medical Center and the closure of a primary care clinic in Waitsfield.
However, on the other side of Lake Champlain, the situation is very different. Over the past several years, UVM Health Network facilities in upstate New York have increased capacity and increased volume for some procedures.
Over the past two years, Champlain Valley Physicians Hospital in Plattsburgh has worked to increase the number of surgeries it performs, according to Annie Mackin, a spokeswoman for the network. During this time, Elizabethtown Community Hospital’s Ticonderoga campus has expanded clinics in women’s health and dermatology. By the end of 2023, a primary care clinic operated by another health organization open at Alice Hyde Medical Centerto Malone. And earlier this year, Alice Hyde hired a general surgeon, network announced in October.
The network hopes to further expand the state’s capacity in the coming years, executives say.
“In New York, we’re doing our best to expand services, to expand opportunities, to be able to have more opportunities to see patients there,” said Steven Leffler, the center’s president and chief operating officer. UVM Medical, in a press release. interview last month.
“We’re hoping they’ll have better inpatient access to cover patients who can’t stay here,” Leffler said, referring to the Burlington hospital. “We hope to be able to move more surgical cases there to ensure access is maintained for people who may, unfortunately, have more difficulty accessing here.”
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“Patient-centered and patient-focused”
The leaders of the network of six hospitals said the additions in New York are simply part of ongoing efforts to help patients more easily access more care — similar to what the network is seeking to do in Vermont.
The University of Vermont Medical Center, Central Vermont Medical Center and Porter Medical Center in Middlebury are all part of the UVM Health Network.
Administrators say recent budget cuts on this side of the lake were due solely to the actions of the Green Mountain Care Board, a state regulatory agency that has capped network hospital budgets and ordered UVM Medical Center to reduce your expenses to private health insurers earlier this year.
The additions at New York hospitals, which are outside the board’s jurisdiction, have nothing to do with the board’s orders and often predate them, network executives said.
This work “is completely independent and unrelated to the regulatory action here,” Sunny Eappen, president and CEO of UVM Health Network, said in an interview.
The expansion of services in New York, however, benefits hospitals in Vermont. In fiscal 2023, New York residents contributed about 14% of the University of Vermont Medical Center’s patient revenue, to the tune of $245 million, according to financial documents submitted to the Green Mountain Care Board.
In Vermont, the Care Committee places limits on how much hospitals can provide through patient care — limits that UVM Health Network officials have said are. expensive and harmful. By increasing capacity in New York, the network can keep some of these patients in their communities and out of Vermont hospitals.
Owen Foster, president of the Green Mountain Care Board, declined to comment, saying he did not know the details of the network’s hospital services in New York.
In 2025, Champlain Valley Physicians Hospital plans to increase operating room capacity for general surgery, urology, otolaryngology procedures and orthopedics, according to Mackin, the network spokesperson. The network has invested in some “anesthesiology resources” for this expansion and is recruiting urology and orthopedics clinicians, she said.
The network also informed about 370 New York patients that they had the option of undergoing imaging procedures — such as X-rays — in the state rather than in Vermont, Mackin said. UVM Health Network is also “evaluating opportunities” to add gastroenterology, cardiology and perfusion procedures in New York, she said.
“It’s patient-focused and patient-centered, right? » Lisa Mark, chief medical officer of Champlain Valley Physicians Hospital and Alice Hyde Medical Center, said in an interview. “So they don’t need to cross the lake if they don’t need to.”
Vermont and New York
In recent months, UVM Health Network has drawn attention to the movement of money between its hospitals in Vermont and New York.
This attention was sparked by the revelation during the Green Mountain Care Board’s annual hospital budget review process that UVM Medical Center in Burlington owed $60 million to Champlain Valley Physicians Hospital in Plattsburgh.
This led to fears that Vermonters were subsidizing New York’s medical facilities. In comments submitted At the Green Mountain Care Board in August, Vermont’s top health care advocate, Mike Fisher, and members of his staff accused the network of “systematically weakening its financial position by choosing to shift funds to hospitals in New York “.
Network executives have repeatedly denied that these transfers — which paid for pharmaceuticals, doctors’ salaries and other expenses — had any impact on Vermonters. These transfers affect a hospital’s cash flow, executives said, but do not affect Vermonters’ commercial insurance margins or rates.
“We’ve been very, very clear about that,” Rick Vincent, the network’s executive vice president and chief financial officer, said in an interview. “Vermont commercial rates are not affected by these New York hospitals.”
Last month, the care committee asked the network for more information about the finances of New York’s hospitals, including their operating margins and liquidity.
UVM Health Network initially declined to provide this information. But Eappen said in an interview that he intends to share hospitals’ financial information with the board.
Some New York hospitals in the network have struggled in recent years, according to publicly available nonprofit tax forms. Champlain Valley Physicians Hospital lost nearly $30 million in its 2022 fiscal year and nearly $40 million in fiscal 2023, according to tax records, and Alice Hyde Medical Center also lost about $20 million over those two years. Elizabethtown Community Hospitalmeanwhile, has recorded positive margins over the past decade.
Eappen said Champlain Valley and Alice Hyde have become more stable over the past year, although financial data is not yet publicly available.
There are “not yet” plans to shift more services to New York following orders from the Green Mountain Care Board, Eappen said. But keeping care close to home for upstate New York residents is a win-win, he said.
“If New Yorkers stay in New York, that doesn’t contribute to Vermont’s revenue,” Eappen said, referring to patient revenues, which are capped by the Green Mountain Care Board. “And so if we do it right and keep New Yorkers in New York, it’s positive on both sides.”