The University of Vermont Health Network has announced cuts to patient services. The hospital network says it’s to comply with enforcement actions required by the state’s health care regulator. But that board says that’s not the case.
In a 10-page press release the hospital network announced plans to make a series of service cuts including ending kidney transplants and reducing the number of overnight patients and incoming non-emergency transfers at its Burlington hospital. Dialysis clinics will close in St. Albans, Rutland and Newport.
The UVM Medical Center is the largest hospital in the health network. President and Chief Operating Officer Dr. Stephen Leffler says the network did its best to make cuts in areas where patients have other options to get the care they need.
“We did our best to try and pick areas where we think that there’s other options for patients to get the care they need. So, for example, transplant we were doing relatively few cases per year, 12 to 15. Those patients could go to Dartmouth and get that care. So not too far away for a relatively small number of people. For dialysis it’s our strong hope those local community hospitals can pick up that service so patients can still get that care,” Leffler explained. “We believe we need a revenue increase of 9.3 percent for ’25 to care for everyone whom we believe will seek care here. And they gave us 3.5 percent. The number of dollars they approved for ’25, the $64 million, is actually less than the revenue that came in in ’24.”
Leffler says the network informed state health care regulators what actions they would have to take if revenue reductions in the current budget orders were upheld.
“In October we sent the Green Mountain Care Board a document that outlined the actions we believed we’d have to take and we explained clearly what we’d have to do. We also asked, when we first heard about the overage in ’23 and there are potential actions on that, we asked for a hearing with Green Mountain Care Board,” Leffler said. “They did not grant us a hearing. They dealt with the budget overage from ’23 in our budget hearing which was in August and didn’t give us a full opportunity to explain all that.”
The Green Mountain Care Board is Vermont’s health care regulator in charge of overseeing and approving hospital budgets. In a statement the panel said it was not consulted nor did it approve the cuts. Chair Owen Foster said he spoke with network representatives the evening before the announcement.
“UVM had made some indications that there could be reductions if their budget was not approved as submitted. But these specific changes that they made were not brought to our attention until the night before they were announced,” Foster said.
The University of Vermont Health Network says the cuts are being made to comply with the Green Mountain Care Board’s enforcement requirements. Vermont Federation of Nurses and Health Professionals President Deb Snell scoffs at that reasoning.
“I am going to call BS on that. I paid attention during the budget hearings. I have read the order. There’s nothing in the order that says ‘oh, let’s stop dialysis and let’s stop mental health care.’ That was not the point of that order,” notes Snell. “UVMMC has done a very poor job being fiscally responsible for a long time and they frankly were less than honest with their finances. They got caught and are facing the consequence on that.”
Foster says the announced cuts don’t align with recommendations the care board had identified to the health network that could help improve access and affordability.
“One of the things that we struggle with in Vermont is a hospital that’s high priced, such as UVM, for commercial insurance. If you increase utilization dramatically it gets very very expensive. And we have problems with insurer solvency and we have problems with people being able to afford health care in this state,” Foster said. “And so one of the avenues we’d like to see a hospital that’s high priced with high expense growth like UVM take is to control the expense growth. And if you control the expense growth you have opportunity to lower those prices and increase utilization without causing financial problems for patients and the state.”
The cuts will be staggered as plans are finalized and no specific dates have been set.
The University of Vermont Health Network will submit a revised budget to the Green Mountain Care Board reflecting the announced cuts.
