New CEO of UVM Health Network hopes to set new tone of cooperation with VT hospitals

Dr. Sunny Eappen has been on a charm offensive since he took over as president and chief executive officer of the University of Vermont Health Network 18 months ago.

Eappen made it his mission to visit the CEOs of every hospital in Vermont, including those who didn't work for him. Both Central Vermont Medical Center in Berlin and Porter Hospital in Middlebury are part of the Health Network, along with the UVM Medical Center.

"I wanted to change the face, or the perception, of us, the UVM Health Network," Eappen said.

The perception, Eappen knows, is of a near-monopoly that has stifled competition and generally made life difficult for smaller independent hospitals and physicians. In 2016, the Burlington Free Press reported on several examples of the UVM Medical Center's heavy-handed tactics against potential competitors , including opposing the construction of the independent Green Mountain Surgery Center , which finally opened in 2018 after nearly two years arguing before the Green Mountain Care Board for a certificate of need. Dr. Stephen Leffler, then chief medical officer of UVMMC and now its president and chief operating officer, said the Green Mountain Surgery Center was not needed, and that it could drive up health care costs in the state.

Now that it wants to build its own $130 million surgery center on Tilley Drive in South Burlington, Eappen said UVMMC was wrong to oppose the Green Mountain Surgery Center.

"Lots of things change," he said. "Steve (Leffler) told me we were wrong, we shouldn't have opposed (the Green Mountain Surgery Center) and we actually said that to the Green Mountain Care Board."

For the people who work there, the perception of UVMHN is 'hurtful'

Eappen said the perception that the UVM Health Network is out to crush the competition is not reflected in the reality he found among employees inside the organization.

"It's actually hurtful to the folks working so hard to serve their patients and communities when they hear that, so we need to change that," he said. "I've gone to all 14 hospitals in Vermont and I've asked them, 'What can we do for you, how can we work better with you?' The reality is that the folks that are here within our network feel a responsibility to the state. We're not competing. It's how do we take care of the state, how do we take care of the people who are here, better?"

About half the hospital CEOs he talked to took him up on his offer, Eappen said, asking for help with electronic medical records, with urology, cardiology and cancer, and with their pharmacy programs.

"Can we simplify our transfers into your ER, how do we do that better?" Eappen said one hospital asked. "We haven't been successful on all of (the requests), but I'd say half of them we've done something tangible on it."

That's about half the hospitals. What about the other half?

"The other half of the hospitals I'd say I'm going to have to make more trips, because there's history," Eappen said. "We haven't built up the trust yet maybe. There's a little tension."

Other hospitals worry UVMMC's new surgery center could take patients away from them

Two of the CEOs Eappen met with were Peter Wright at Northwestern Medical Center in St. Albans and Joe Woodin at Copley Hospital in Morrisville. Both hospitals raised concerns about UVM Medical Center's plans to build an outpatient surgery center, after being granted interested party status by the Green Mountain Care Board. Both hospitals said they have operating room capacity that is not recognized in UVMMC's application for a certificate of need, and both fear the new surgery center could take away patients from them.

One of the Green Mountain Care Board's responsibilities in granting or denying CONs is to make sure any new medical facility that gets built is necessary, as part of the Board's job to keep health care costs in Vermont as low as possible. UVMMC's proposed surgery center will have eight operating rooms, replacing the five ORs currently in use at the Fanny Allen campus. The new surgery center will also have the capacity for an additional four ORs, for a total of 12.

"As the GMCB works through the CON process, they must consider that surgeries, which can be appropriately done at Copley, should remain at our facility," Woodin told the Care Board. "Our ability to maintain financial sustainability in both fee-for-service and value-based models depends on efficient use of our existing infrastructure. Any loss of surgeries from our facility weakens Copley."

CEOs of Copley Hospital and Northwestern Medical Center adopt a wait-and-see attitude

Eappen said he met with both Wright and Woodin when he became aware of their concerns about the proposed surgery center. He assured them the surgery center was intended for Chittenden County patients only, in an effort to reduce wait times. Eappen pointed out that in a May 20 hearing before the Green Mountain Care Board, neither Wright nor Woodin raised concerns about the new surgery center taking patients away from their hospitals.

"Neither one of them had anything negative to say," Eappen said. "They spoke because they were asked to speak. They didn't bring up this issue because they know that's not real, so I think those conversations do help."

Wright told the Burlington Free Press he's satisfied with what Eappen has told him about the surgery center, for now.

"I think I'll take them at their word until they give me a reason not to and we'll see, we'll see what happens," Wright said.

Woodin said eight ORs, with the possibility of four more, is "just a lot of ORs." Copley has three ORs, but is "looking at needing another one," because of the demand for its orthopedic surgeons.

"The beauty of Vermont is we do think relationships are important, communities are important," Woodin said. "Hopefully we'll continue in that vein in this project and others to support each other. Hopefully we'll do it in a way where there's not winners and losers."

Wright: Eappen represents a 'refreshing change' from the past

Wright has met with Eappen roughly quarterly, or about four times, he said, and has been "impressed and pleased with every encounter we've had."

"We've talked about how do we want to define our relationship and work together," Wright said.

Eappen acknowledged the relationship between Northwestern and UVMMC was "not necessarily productive in the past," and said he wanted to have a "very productive" relationship with Northwestern and all Vermont hospitals in the future.

"It's a refreshing change," Wright said. "(Eappen's) predecessor felt everything should come to UVMMC, other hospitals would be ERs and primary care centers. If you need surgery or anything significant you should come to the Medical Center. That was a vision and thought process I did not agree with, and I think history has shown that's not really a good idea. All hospitals (in Vermont) are quite busy."

More: Vermont has problems finding hospital beds for those in need. What a doctor says causes it

Eappen expects a decision from the Green Mountain Care Board on the proposed Surgery Center's CON by July 28. He said UVMMC has included a $20 million contingency into the budget for the facility, which would push the total cost to $150 million if it's needed.

"Two things have happened in the 18 months (of the CON process) right?" Eappen said. "Everything costs more, the interest rates have gone up, so the cost of the project is going to be higher. I think we're prepared for that. We hope we can start soon, otherwise our patients are struggling and the waiting goes on even longer."

Eappen was preceded as president and CEO of the Vermont Health Network by Dr. John Brumsted, who retired in September 2022.

Eappen explains what's different about Vermont compared to Boston, where he worked for decades

Before taking over the top job at UVM Health Network, Eappen had a 25-year career in Boston, where he most recently was chief medical officer and senior vice president for medical affairs for Brigham and Women's Hospital, part of the Mass General Brigham network. He was also interim president of Brigham and Women's from March 2021 to December 2021, when a permanent candidate was selected, according to a news release.

Eappen said Brigham and Women's alone is much larger than the UVM Health Network, with 22,000 employees, compared to 15,000 in the Health Network. Brigham and Women's also generated more revenue than the Health Network, about $4 billion annually compared to $3 billion for the Health Network. Brigham and Women's and Mass General are the top two research hospitals in the country, according to Eappen. But Eappen said the UVM Health Network has something else going for it.

"What's different here and it's universally true I'd say, is I think our caregivers, doctors, nurses, nurse practitioners and physicians assistants are totally committed to their patients," he said. "It's like they're taking care of their friends, neighbors and family members, because they are. It's a different level of patient care and community commitment than I've experienced before."

Eappen was careful to add that it's not that the doctors in Boston didn't care about their patients, but there's a different sense of community here that doesn't exist there.

"I'm generalizing, but we're really lucky to have that," he said.

Contact Dan D’Ambrosio at 660-1841 or ddambrosio@freepressmedia.com. Follow him on Twitter @DanDambrosioVT.

This article originally appeared on Burlington Free Press: New CEO of UVM Health Network hopes to set new tone of cooperation with VT hospitals