Health Care

Del Trecco: Understaffed VT hospitals struggling with inflation, patient placement, violence

by Mike Del Trecco, VAHHS

It’s once again time for our non-profit hospitals to go before the Green Mountain Care Board (GMCB) to present their budgets for the next fiscal year.

Mike Del Trecco

Vermont hospitals have gone through an extensive process of evaluating revenues, expenses, challenges and the needs of their people, patients and communities. Each hospital budget has been reviewed and approved by a community board with members who understand their communities, hospital-specific

challenges and, of course, the importance of affordability.

As I’ve said before, these are “stabilization budgets,” and come at a time of immense uncertainty in health care. It is essential to our health care system that these budgets be approved as submitted.

I have been working in health care for my entire career and I have never seen a set of circumstances so complex and severe—this is not normal:

  • We face a workforce challenge like never before, 65% of these budgets goes toward covering expenses related to workforce and building operations. Hospitals operate 24/7 and 365 days a year and we cannot close if things are too expensive or for lack of personnel.
  • We are experiencing unprecedented inflation and supply chain issues that are contributing to skyrocketing costs; over 30% of these budgets goes toward purchasing medical and surgical supplies and pharmaceuticals to care for patients.
  • Adding to these challenges is the fact that many of our patients are coming in sicker and need more extensive care. To provide some context, over the past three weeks as a system we have been at 93 – 96% capacity and unfortunately, this is becoming a trend, not a one-time occurrence.
  • We have a stressed mental health and long-term care delivery system that places incredible pressure on our hospitals. This drives up costs as patients are stuck in hospitals even when they don’t need to be there. Just yesterday, we had 125 patients waiting for placement and over the last three weeks this number was between 105 and 138. Again, this not a one-time occurrence.
  • We are still managing the pandemic and preparing for the potential of Covid surges. And we’ve only just started the conversation around Monkeypox.
  • Caregivers at our hospitals are experiencing violent acts against them daily.

Under our current regulatory structure, we have not been able to grow our budgets to match the rate of medical inflation for many years predating the pandemic and recent economic downturn. As a result, the current inflationary pressures are hitting us even harder than other industries.

Unfortunately, these issues have taken a toll; our workforce is exhausted, our communities are challenged and for the current fiscal year, most of our Vermont hospitals are reporting loses. Operating with budgets lower that those submitted will jeopardize services and challenge the investments that are necessary to run our hospitals and care for our communities.

So much of what we talk about in this space are the numbers, but for our hospitals, this is anything but a numbers exercise. Behind every figure are people who will be impacted—staff, providers, patients and non-profit community partners. Our hospitals provide a tremendous value to the communities they serve; they are places where patients and their families go for care; they are places of hope and healing. And in many ways, they are the economic hubs of the communities they serve.

The stabilization budgets now before our regulators are thoughtful and needs-based and I urge the Green Mountain Care Board to approve them as submitted.

The author is the interim president of the Vermont Association of Hospitals and Health Systems.

Categories: Health Care

7 replies »

  1. “Adding to these challenges is the fact that many of our patients are coming in sicker and need more extensive care. To provide some context, over the past three weeks as a system we have been at 93 – 96% capacity and unfortunately, this is becoming a trend, not a one-time occurrence.”

    Huh I wonder what would have caused all that? Couldn’t be an experimental drug you pushed in to people’s arms…

    Now you’re on here begging for more money.

  2. The problem with Mr. Del Treco’s perspective is he is only thinking about his “client”, Vermont hospitals. He offers no consideration for the impact of 10% budget increases on health insurance premiums and out-of-pocket costs that citizens in the State may experience.

    Moreover he shows no understanding of the current state of the aggregate federal budget deficit, now just under $31 Trillion dollars.

    With 95 million Americans now covered by Medcaid (thanks to the Biden Administration continuing a state of emergency associated with COVID), AND ever increasing costs associated with Medicare (note that premiums of people paying into the system and the reserves of the Medicare trust fund—which will be depleted in 2026 –do NOT currently cover all Medicare expenses… federal dollars are needed to maintain operational stability of healthcare for the elderly), hospital budgets that increase beyond what society and the government can tolerate are destructive to the social good.

    Health care personnel salaries are very generous (not to mention the extraordinary amount of excessively paid management positions). Along with status as non-profit institutions (that pay little in taxes) hospitals often have multiple revenue streams. They should not take ever-increasing amounts of earnings and savings from the citizenry.

  3. Gosh I think he maybe should call a few Big Pharma (Pfizer ect ect), I’m sure since he and his like are the “legal” drug pushers…….they would be happy to donate (tax deductable of course) a billion or 2……..

  4. Talk to Fauchi, maybe he can cook up a new revenue generating virus for you’s all…Biden will be on standby with the stimulis checks for all the patients you put on death ventilators…In the mean-time, keep denying all medical care to those who refuse to get vaccinated with experimental clot-shots….No sympathy and no trust for medical care in this country anymore…& the medical profession earn’t that all on it’s own.

  5. Anonymous sure demonstrates ignorance of the problems explained. The Green Mountain Care Board show no awareness of the shortfall of the reimbursement of the uninsured, Medicaid and Medicare reimbursements combined with the additional costs of hiring gig nurses.
    Wake up. The cost is there. If the hospital isn’t paid the full cost of the services provided, the other private patients must make up the difference. Government only shifts the cost, it doesn’t change it. Write or call your representative and explain you expect your hospital to be there when it is needed and not to have to personally subsidze the majority of the patients.

  6. Are citizens EVER going to hold these bureaucrats responsible for the sizable mess we have on our hands? These bureaucrats conspired to train wreck the health care in the US by giving us slogans such as “if you like your Doctor, you can keep your doctor”, we’re going to “lower the cost of health care”, “health care for all!”, etc etc. Now we have a continued spiraling , out of control cost problem, a supply problem of providers (e.g. where preventative care now takes 6-8 months to be seen for an appointment. ) and discouraged citizens. We are now reaping what we have sowed. Keep falling for these bureaucrat promises/slogans and watch the demise continue across our health care.