Dr. Stephen Leffler: Working together to address Vermont’s health care challenges

This commentary is by Dr. Stephen Leffler, president and COO of the University of Vermont Medical Center.

As Vermont’s population ages and in many places declines, we’re seeing the impact in all aspects of our daily lives — whether it’s housing, education or health care.

What’s the core problem in Vermont’s health care system? At its most simple, the number of people paying for care through commercial insurance is going down (and getting older and sicker), while nationally and locally the demand for care and the cost to provide care is going up.

This trend is unsustainable, and to address it, care providers, insurers and government will need to avoid the divisive brinkmanship we see on the national stage and embrace Vermont values of community and collaboration to find the solutions that increase access to care and lower costs overall.

At University of Vermont Medical Center, we know controlling costs is a key part of the above equation and a part of our nonprofit mission. Multiple sets of independent data show that when it comes to administrative costs, we’re one of the financially leanest academic medical centers in the Northeast.

This isn’t by accident — as part of UVM Health Network, we’ve put a lot of work into reducing costs through efficiency sharing administrative staff and as we become unified, even sharing providers. This improves care for patients across our region while controlling costs.

To support our vital work, on Aug. 28 we presented to our regulator, the Green Mountain Care Board, our commercial rate increase request of 7.91% for FY25 , which begins on Oct. 1. Our proposed budget for the next fiscal year includes a number of significant initiatives supporting our patients and communities, including:

• Strengthening access to care: We’ve significantly reduced the number of patients waiting for necessary surgeries this year by performing a record number of procedures month after month. We’ve expanded capacity for imaging, added mental health services into primary care offices and increased the availability of virtual consults. In the coming months, primary care will see significant changes and expansion in terms of access.
• Investing to meet patient needs: As our population ages and grows, demand for more complex services will only continue to increase. We’re working hard to be ready for the needs of our communities. One example of this is increasing available imaging equipment to drive down wait times.
• Investing in our employees: We recently ratified a nursing contract, increasing wages by 23% over the next three years, and we are also investing in nationally recognized workforce development programs to recruit and retain the talented people we need to deliver the highest-quality care. The minimum wage at UVMMC is now $20/hour. We have also made investments in childcare and housing to attract and retain our workforce.
• Controlling our costs and addressing affordability: We’ve expanded financial assistance programs to ensure no one is denied care due to financial constraints. Last fiscal year, across our health system, these programs covered more than $22 million in the cost of care and nearly $6 million in prescription drugs for patients in Vermont. We are very focused on doing our best to make sure we are responsible stewards of Vermonter’s health care dollars — including tight cost control and finding alternative sources of revenue to ultimately reduce premiums. This work reduced our FY25 rate increase ask by $31 million.

These efforts are crucial, but they are not enough on their own. We need help from every part of our society to make Vermonters healthier. We need to find new ways to fund health care and we need a stronger continuum of care — especially when we discuss caring for the most vulnerable among us.

We look forward to a continued conversation with our partners throughout the system to leverage every opportunity to take pressure off commercial insurance premiums in Vermont. None of it will be easy, but it can be done. It will take collaboration from our state government, regulator, insurers and the hospital system to make progress on affordability while preserving access to trusted local care.

To learn more about the impact of our work across UVM Health Network, please visit UVMHealthImpact.org . We’re in this together, and by working collaboratively, we can overcome the challenges ahead.

Read the story on VTDigger here: Dr. Stephen Leffler: Working together to address Vermont’s health care challenges .