Last week news broke that the Green Mountain Care Board had increased the revenue cap it set for the University of Vermont Health Network. Subsequently UVMHN announced it would not be closing or selling its three dialysis clinics in northern Vermont.
The Valley Reporter reached out to UVMHN, the Green Mountain Care Board (GMCB) and the Central Vermont Health Network, seeking information as to whether there would be any effort to further increase revenue caps so that Mad River Family Practice in Waitsfield could remain open.
The short answer is/was “no.”
Last fall UVMCHN/CVMC said that GMCB revenue caps necessitated significant cuts, including closing the local health care clinic later this year. CVMC’s CEO Anna Noonan has stated that the local clinic loses a significant amount of money, although the organization has refused to share any relevant financial data
UVMCHN spokesperson Annie Mackin said that the UVMHN’s request to the care board was specific to dialysis.
“We have not made the same request regarding other steps announced in November, all of which have either already happened or continue to move forward,” she said.
Mackin said that it was due to the life-saving nature of dialysis that UVMHC asked the care board to increase its revenue cap for the network to continue to provide that care.
CVMC spokesperson Jay Ericson did not return a call about whether the organization had or would reach out to the care board to determine if any further revenue increases would be permitted to allow the local health care clinic to remain open.
GMCB spokesperson Kristen LaJeunesse said that the care board establishes budgets for individual hospitals.
“In its budget orders, the GMCB points to specific areas of improvement it believes a hospital can implement to operate within its established budget. It does not require hospitals to follow these recommendations. After CVMC’s budget was established, it chose to cut services rather than pursuing other options,” she wrote.
“After a budget has been established, a hospital can apply for a budget adjustment based on exceptional or unforeseen circumstances. (See 18 V.S.A. § 9456(f).) UVMMC applied for an adjustment of $5.7 million to its approved budget for the purpose of continuing to operate dialysis services. The GMCB reviewed and approved,” she said.
“CVMC has not applied for an adjustment to its FY25 budget. As a result, CVMC’s cuts to these services are not matters before the GMCB. Regardless, the GMCB requested information from CVMC to better understand why the hospital determined it was necessary to make these cuts,” LaJeunesse noted.
“If CVMC applies for adjustment to its budget, the GMCB will review that request and issue a determination as it would for any other hospital,” she added.
Part of the reasoning behind closing the Mad River Valley clinic is that people who can’t drive to Waterbury to see their providers (either due to lack of a car or time or public transportation) has been that they can avail themselves of telehealth options.
Given the current climate in Washington, DC, and potentially diminished or cut federal funding for telehealth as of April 1, Mackin was asked if UVMHN /CVMC/GMCB would make any changes to its plans to close this clinic and rely on unfunded telehealth options.
“As for the climate in Washington, DC, at this point we are monitoring the many announcements coming from the new administration, and analyzing their potential implications for our patients, staff and communities,” she said.
The Valley Reporter’s question and her answer took place prior to the late night, February 25 vote by Congress to slash $880 billion in Medicaid spending.
LaJeunesse was also asked about potential federal cuts to Medicaid, prior to the February 25 vote.
“GMCB is aware of and shares the concerns of many about potential changes to federal funding. However, decisions about clinic operations and the use of telehealth as an alternative to in-person care are determined by UVMHN. Questions about whether UVMHN’s plans may change in light of possible federal funding reductions would be best directed to them,” she said.
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