Collaboration Needed to Preserve Health Care Services

I am writing to express my deep concern about the recent decisions made by the Green Mountain Care Board regarding hospital budgets.

Earlier this month, the GMCB mandated Rutland Regional Medical Center reduce its net revenue by $6.3 million beginning Oct. 1. The basis used by the GMCB to mandate the reduction is simply that RRMC provided too much care to patients, which is resulting in higher revenue and higher costs to insurance companies. While RRMC leadership and its board of directors understand the high costs of health care, and are committed to working in partnership with local agencies and state government leaders to address, we firmly believe simply reducing access to care is the wrong response.

Our budget as submitted to the GMCB reflected investments to increase critical services, specifically, diagnostic imaging, surgery, infusion therapies and specialty care. These investments were targeted to reduce testing delays and help patients gain faster diagnoses and treatment plans, all aimed to begin treatments earlier.

We know it can take too long to gain access to advanced imaging for MRI and CT services, to be scheduled for a necessary surgery or to have a colonoscopy performed. Our wait times in our clinics are also too long, which can prevent timely care. Our budget considered improvements in each of these services.

The GMCB decision to reduce access to care, without a doubt, undermines the ability of RRMC to meet the needs of the communities we serve. The reductions in our hospital’s budget, and the budgets of other Vermont hospitals, do not achieve the affordability goals we collectively share. Instead, they threaten access to care and place the health of Vermonters at significant risk. Unfortunately, the impact of the GMCB decision will force RRMC, along with most other Vermont hospitals, to reduce care.

As an example, budget restrictions of this magnitude would mean longer wait times for MRI scans, surgeries and visits within our medical specialty clinics. These are not just numbers; they are people, our community members, who will now face unnecessary delays in receiving the care they so desperately need.

It is also important to note, the demand for RRMC services continues to grow … not only from Rutland County but from communities across the state. Patients are traveling to RRMC to receive high-quality and timely care, which demonstrates the exceptional service and care we provide. Yet the GMCB is restricting our ability to serve these patients. Overall, the restrictions to provide care will force patients to seek care outside of Vermont. This will not result in savings to our commercial insurers or our patients.

More importantly, those who cannot afford to travel — the most vulnerable among us — will be most impacted. These individuals and families will be left without the care they need, without the timely MRI to detect life-threatening conditions, and without the surgery needed to return to their life and their work. This delayed care will result in our community members becoming sicker and health care costs more expensive when it is forced to be delivered in emergency care settings.

While focused on increasing access to care, Rutland Regional has also continually been committed to finding ways to reduce health care costs. During the past few years, RRMC has cut more than $10 million in operating costs, which has directly served to reduce the cost of care, despite rising inflation.

Rural hospitals like RRMC face significant challenges, including an aging population, increased mental health needs, addiction, housing shortages, recruitment challenges, limited access to child care, and of course, access to health care. RRMC is a safety net for our community. But that safety net comes at a great cost, and it requires thoughtful, diligent support.

To truly reduce costs and improve access, we need a comprehensive approach. We need more skilled nursing beds, a functional statewide ambulance system, solutions to homelessness, and transitional housing for those who are not sick enough to be in the hospital but have nowhere else to go. This is the challenging work of health care, and this burden cannot, and must not, fall on hospitals alone.

RRMC is committed to this work, and we are committed to our community. But the decisions made by the GMCB last week jeopardized RRMC’s ability, and the ability of other Vermont hospitals, to meet these critical commitments. We need collaborative partners who understand that cutting budgets does not cut the need for care.

RRMC is ready to work with the GMCB and partners across the state of Vermont to find solutions that ensure access to care for our patients. But the GMCB’s recent actions are not collaborative and do not feel like a partnership.

Regardless of the information we have presented, the impacts we have shared, the actions of the GMCB will have consequences, many of which cannot be easily reversed and will create challenges for the most vulnerable people in our communities.

As CEO, it is my responsibility to ensure RRMC provides consistent, timely, high-quality care for our patients … care they need and deserve. Rutland Regional will continue to advocate for preserving services vital to the health and well-being of our community.