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.
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.