The Vermont Association of Hospitals and Health Systems (VAHHS) today announced that its non-profit hospitals submitted what they are calling “stabilization budgets” to the Green Mountain Care Board (GMCB). Hospitals continue to experience high patient volumes with many at or exceeding their capacity to deliver care. Additionally, the entire health care system is stressed, so patients are presenting sicker or in need of more services due to delayed care or must remain hospitalized because there are no care options in long term care facilities or the community.

VAHHS said hospital budgets are unique to the organizations creating them and reflect their values and commitments and the realities they face. Since the pandemic, hospitals have experienced significant and increased financial strain exacerbated by the recent economic decline and a growing workforce shortage.

In this current fiscal year, nearly all hospitals are experiencing a negative operating margin, meaning they are losing money. In response, hospitals are engaged in strategic plans to cut costs and reduce spending where possible to protect vital services.

The hospitals are seeking commercial rate increases, regulated by the GMCB, to provide the resources necessary to achieve quality care, invest in aging equipment and buildings and provide competitive wages for their hard-working staff and providers.

The state's highest court ruled Friday that Vermont's elected auditor does not have the authority to review employee payroll information of OneCare Vermont, the private, state-contracted accountable care organization tasked with overseeing $1.3 billion of Vermont’s health care costs.

The Vermont Supreme Court’s unanimous 13-page ruling is the latest chapter in a two-year legal battle that pitted Auditor Doug Hoffer against OneCare in a test that ultimately challenged the reach of the state auditor’s office.

The University of Vermont Health Network wants to charge commercial insurance companies an extra $140 million next fiscal year to help cover rising inflation and labor costs at its three in-state hospitals. 

The requests represent double-digit percent increases over what the hospitals now charge and could have major implications for the cost of health care in Vermont, where many privately insured people are already struggling to keep up with inflation — at the gas pump, in the grocery store — and have long said they can’t afford to pay higher premium rates. 

The network says it has no choice. Blaming high inflation, unrelenting workforce shortages, years of unfavorable regulatory decisions and a rash of pandemic service reductions, UVM leaders say their hospitals have been burning through their reserves at an unsustainable rate and desperately need a lifeline. 

The Centers for Medicare and Medicaid Services (CMS) is approving an extension of Vermont’s Medicaid section 1115 demonstration, “Global Commitment to Health.” This extension will enable the state to continue to test, monitor, and evaluate a managed care-like delivery system, home and community-based services, and novel pilot programs, as well as pursue innovations to maintain high-quality services and programs that are cost-effective. Overall, the demonstration extension will continue to promote health equity by expanding coverage and access to services.

“I’m proud to approve this demonstration extension, which will expand access to behavioral health care, home and community-based services for seniors and people with disabilities, and whole-person care focused on treating substance use disorders and mental health needs during pregnancy,” said CMS Administrator Chiquita Brooks-LaSure. “Vermont is also strengthening its data collection system, which will give us better information about the impact of the state’s demonstration and could inform future policymaking.”

In May 2022, the New York Times reported on a heartbreaking situation unfolding at a local emergency department (ED).

Fifteen adolescents in mental health crisis (many of them experiencing suicidal ideation) were essentially living in the ED, sleeping there night after night. These kids desperately needed intensive residential treatment. However, wait times for a pediatric psych bed averaged 10 days across the region.

This shocking story drives home a hard truth. If any patient group is overdue for a compassionate, patient-centered approach, it’s the emergency psychiatric population. Ironically, this group encompasses both the highest-acuity mental health patients and the most underserved.

Up to 15% of emergency department visits now involve behavioral health emergencies, including substance use and mental health crises. Yet in managing these patients, too many hospitals adhere to historically inefficient care models that benefit few—and may actually cause patients’ symptoms to worsen.

Numbers show racial inequity in health care is still a big deal. Data from the Vermont Department of Health shows adults of color are almost twice as likely to delay getting care because of the cost, among other statistics highlighting the issue.

“We can’t talk about health care without talking about health equity at the same time,” said Dr. Jackie Hunter, SVP chief diversity and inclusion officer at UVM Health Network.

COVID-19 highlighted racial inequities in health care, but Hunter said the problem has always existed. She spoke to WCAX News about her own experience after the birth of her first child.

“I was septic. I almost lost my life. It actually took an ally to come in and demand certain tests were performed,” Hunter explained.

June is Men’s Health Month, and even though the month is coming to an end, it’s never too late to take of yourself. Dom Amato spoke with Dr. Natasha Withers, a primary care physician at Porter Medical Center in Middlebury about the importance of men calling up the doc. You can watch the interview above.

Heat-related illnesses in Vermont become much more common when temperatures warm to the mid-80s and above, especially on sunny and humid days. Temperatures Friday could reach 90. With summer kicking into high gear and the thermometer moving up, the Department of Health has unveiled a new interactive map where Vermonters can find nearby places to cool off during hot weather.

“As we begin our annual adjustment to working and being outside in warmer weather, it’s important to know where you can go to cool off and stay safe,” said Jared Ulmer, climate and health program manager for the Health Department. “Vermonters can use this new map(link is external) to find air-conditioned buildings, beaches, pools and other cooling locations available to the public.”

Warm temperatures, and especially extreme heat and humidity, can quickly lead to sometimes serious heat-related illness and even death. Muscle cramps, heavy sweating, nausea, headache, or dizziness may all indicate onset of heat illness.

Ulmer encourages everyone to be aware of the weather forecast and to know how to stay safe.