By Michael Bielawski
The Green Mountain Care Board has stated that they are not forcing any hospitals to close, despite first issuing a report on hospital finances that includes recommendations that some do close.
The Green Mountain Care Board Chair Owen Foster says, “The Oliver Wyman report does not mandate any changes at any Vermont hospital. Rather, it provides a projection of Vermont’s financial headwinds and provides options for local communities and hospital leaders to consider.”
The full press release can be read here.
The Wyman report was the result of a legislative mandate. Act 167 passed in 2022 requires that the GMCB in collaboration with the Agency of Human Services develop a new approach to healthcare that increases access and affordability.
Foster continued about the shortcomings the report found.
“Vermont has gaps in care to essential services, including long-term care and home health and hospice, mental health care, and primary care, that the Oliver Wyman report identifies and provides options for addressing,” he said. It notes that nine of the state’s 14 hospitals are operating at a deficit. Multiple hospitals were recommended for closing or drastically relocating core services, in one case prompting a town mayor to respond.
“I can’t think of anything that would more discourage the investors and development we are trying to attract to the region than to have the State communicate that we so little value the communities in this remote and isolated part of the State that we are as a State going to just gut our health care infrastructure here,” Newport’s Mayor Linda Sullivan said in September.
The Wyman report offers three strategies to compensate for a hospital’s closure. They are to refer inpatients to “regional specialty centers”, to address patients’ acute healthcare needs “within a reasonable distance” and to “address community members’ social needs previously treated in the hospital setting.”
Back in July, the GMCB issued a dire statement about the long-term viability of Vermont’s hospitals. “Unless immediate decisive action is taken to transform Vermont’s health care system, it will be financially unsustainable by 2030,” they said.
The Wyman Report’s executive summary notes Green Mountain State’s aging demographics. “Overall population is aging – individuals >65 years old are projected to exceed 30% of the total population by 2040 which will exacerbate current strains on the healthcare system due to increasingly complex care needs.” It says what this means for the workforce.
“Working age population declines (-13% by 2040) will intensify workforce shortages and limit contributions to commercial healthcare premiums, rendering cross-subsidization increasingly unsustainable as a financial strategy.”
In addition to high costs, the report suggests that overall access is not great.
“Primary and specialty care clinics have long wait times preventing patients from seeing providers for urgent/routine visits in a reasonable timeframe,” it states. In the section on inequities, they encourage hospitals to provide “culturally competent care” for those with unique “gender/sexual identity.”
On rising costs, the average premiums for the silver exchange plans are $985 for 2024. This constitutes a 108% increase in six years. It further notes a, “60-80% increase in individual, small group plan premiums in the past 6 years.”
Hospital closures made national headlines when GOP vice-president candidate JD Vance suggested that illegal immigration could be bankrupting healthcare providers.
“I guarantee it is an immigration issue because we’re bankrupting, bankrupting a lot of hospitals by forcing these hospitals to provide care for people who don’t have the legal right to be in our country.”
The author is a writer for the Vermont Daily Chronicle