Message from the CEO
VAHHS Urges the GMCB to Approve Hospital Stabilization Budgets as Submitted

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.
VAHHS Annual Meeting
In the News
Vermont hospital officials detail need for Green Mountain Care Board to approve “stabilization budgets”

Vermont hospitals and health care systems must submit their budgets to the Green Mountain Care Board for approval or adjustment. The annual assessment began in late July and nearly all hospitals in the state are asking for their highest rate increases since the board was created in 2011. The association representing hospitals held a virtual meeting Thursday to explain why they need the board to approve what they are calling “stabilization budgets.”

All Vermont hospitals were required to submit their budgets to the Green Mountain Care Board by July 1st. Hearings are scheduled during the weeks of August 15th and 22nd. The board must then change, approve or reject each budget by September 15th
VAHHS and hospital leaders seek GMCB support for ‘Stabilization Budgets’ during budget review

Vermont Business Magazine The Vermont Association of Hospitals and Health Systems (VAHHS) urged the Green Mountain Care Board (GMCB) to approve their budgets as submitted as they prepare for hospital-by-hospital hearings with the regulatory body beginning next week. Hospitals are calling their fiscal year 2023 budget request “stabilization budgets,” as continued staffing shortages and high demand for care and historic inflation stress the system almost to a breaking point.

Most hospitals are requesting double digit increases this year. The hospitals maintain that between the pandemic, global supply and workforce issues, rising costs and tight budgets going back several years, that most hospitals in Vermont are running a deficit and need the increase simply to hold their ground.
Vermont hospitals plead with regulators to approve budgets

Leaders of Vermont hospitals are asking for regulators to approve their budgets in full, and they say their systems are still under stress.

Most hospitals are asking for big budget increases next year, mostly because of paying traveling nurses, inflation and supply chain woes.

Thursday morning, leaders from several hospitals said patients are sicker and staffing shortages continue. They are pleading with regulators to approve their requests in full.

“All of these issues are taking its toll. Our workforce is exhausted, our communities are challenged and for the current fiscal year, most of our Vermont hospitals are reporting losses,” said Mike Del Trecco, the interim president and CEO of the Vermont Association of Hospitals and Health Systems.
Vermont hospitals looking to raise budgets ahead of GMCB hearings

Hospitals across Vermont are looking to raise their budgets.

The Green Mountain Care Board is preparing to begin its yearly budget review hearings, and many hospitals are asking for commercial rate increases in the double digits.

The Vermont Association of Hospitals and Health Systems said inflation, higher volumes of sicker patients and workforce shortages are putting a strain on the system as well as the staff in charge of care.

"Every day, we watch our patients struggle because they are not in the appropriate care setting," said Lori Profota, Chief Nursing Officer at Copley Hospital. "We are at capacity everywhere."
SVMC, citing deficit, seeks budget increase from Green Mountain Care Board
The Bennington Banner

Southwestern Vermont Medical Center is asking the Green Mountain Care Board to approve a $188,872,209 budget for fiscal 2023, a 6.35 percent increase over its 2022 approved spending plan.

The hospital, the county’s largest employer, cited the need to address a projected operating deficit — its first since 2009 — and increasing staffing costs in a presentation published on the Green Mountain Care Board’s website.

According to the presentation, which the board is scheduled to consider Monday, the hospital is projecting a $1.3 million loss for fiscal 2022. A sharp increase in budgeted expenses outpaced a smaller increase in revenue, according to the presentation.

Mental health crisis continues to affect Vermont youth despite high national ranking for child well-being

A national survey has ranked Vermont fifth in the nation for overall child well-being, but indicates there’s been a decline in key child mental health indicators in the state.

The Annie E. Casey Foundation, a national nonprofit focused on improving child welfare, announced Monday the 2022 KIDS COUNT, an annual 50-state report that uses 16 indicators in four domains to rank states based on child well-being.

This year, Vermont ranked 12th in economic well-being, fifth in education, third in health, and third in family and community.
USDA invests $74 million to improve health care; $1M to Springfield Hospital

Vermont Business Magazine US Department of Agriculture (USDA) Rural Development Under Secretary Xochitl Torres Small today announced that USDA is awarding $74 million in grants to improve health care facilities(link is external) (PDF, 321 KB) in rural towns across the Nation. These grants will help 143 rural health care organizations expand critical services for 3 million people in 37 states, Guam and Puerto Rico. The investments include $32 million for 67 rural health care organizations to help more than 1 million people living in socially vulnerable communities, and include $1 million to Springfield Hospital in Vermont.
Medical deserts: What they are, where they are, and who they affect
Washington Examiner

Millions of Americans are receiving healthcare that rivals Third World standards. Vast regions of the country have seen medical services evaporate over the past decade. Hospitals have closed, doctors have left, and pharmacies have been forced into bankruptcy. In this series, Dried Up: America's Medical Deserts, the Washington Examiner will investigate what happened to these now barren terrains. Without adequate access to a hospital, primary care center, OBGYN, or other specialized medical services, the health of an estimated 30 million people is put in jeopardy.

The United States may be a First World nation, but millions of Americans are receiving healthcare that rivals Third World standards.
Hospitals in the News
From our Hospitals
Dougherty: Understanding the hidden life of trees—and hospitals

By Christopher J. Dougherty, President and Chief Executive Officer of Brattleboro Memorial Hospital

Arguably, our large brains make human beings the most intelligent species on earth. Yet only now are we coming around to a full scientific and perhaps even spiritual appreciation of the deep and interconnected relationship we have with the natural world.

As we learn from Peter Wohlleben’s 2015 book The Hidden Life of Trees: What They Feel, How They Communicate—Discoveries from a Secret World, trees are actually smart! And not only do they play an invaluable role in maintaining the health of our planet, they have sophisticated survival strategies and coping mechanisms that are easily overlooked or taken for granted by the untrained eye.

I would argue that just as trees are essential to the life and future of the planet, community hospitals like Brattleboro Memorial Hospital (BMH) have an analogous role in the regions they serve. As such, we must nurture, support and guide these vital community assets or we place ourselves in peril.
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