This week’s writer is Dr. John Brumsted, MD, president and CEO, UVM Health Network, CEO, UVM Medical Center
Many Vermonters — including health care providers — feel uncertain and concerned about the future of health care in light of the significant political changes the national elections triggered. We want our patients to know that regardless of these developments, the University of Vermont Health Network is committed to improving quality and controlling costs by continuing to work closely with Vermont’s hospitals and providers of all types to keep you healthy, instead of just treating you when you’re sick.
Uncertainty is nothing new in health care. Providers in Vermont have continued to make progress despite the unpredictability of our environment by focusing on what’s most important; what is best for our patients and their families. This is what we’ve dedicated our lives to doing, and we know it produces the best results.
We believe that a coordinated system of care focused on keeping you healthy, instead of the current fragmented model that financially rewards the quantity of care, is the most effective way to improve quality, maintain access for all Vermonters and control costs – goals we enthusiastically share with state and federal policymakers and the public.
To be sure, providers of all types have worked with each other and state policymakers for decades, and we have excellent quality and good access to care as a result. But it will take even closer collaboration if we expect to improve our current health care system further, and especially make care more affordable.
The need for closer collaboration began about five years ago when the federal Affordable Care Act encouraged providers to share responsibility for the cost as well as quality of care. In just those few years, we’ve achieved a greater level of cooperation in Vermont’s health care system than ever before, something I believe is worth celebrating.
And coordination is working. OneCare Vermont — a network of most of the state’s nonprofit hospitals, independent physicians, Federally Qualified Health Centers and hundreds of other providers — has achieved positive results in the last several years taking this approach:
Across the network, Medicare quality scores rose 15 percent, reaching 92 percent.
A primary care practice in central Vermont improved management of heart failure patients, resulting in a 50 percent decrease in emergency room visits, and a 75 percent drop in hospital admissions.
A team in Chittenden County worked with primary care providers to increase use of hospice services to improve the quality of life for patients, and saw an average increase of 81 percent.
As our focus has shifted to keeping people healthy to avoid costly medical treatments, we are seeking innovative ways to make this happen. It turns out that the most effective approach must include concentrating on access to adequate housing, healthy food and other key needs, as these factors have the greatest impact on one’s health status. For example, the collaboration between the UVM Medical Center and several other local nonprofits to provide safe housing for people experiencing homelessness resulted in improved health and a 60 percent drop in the cost of care for those individuals over one year.
Our success with a collaborative model led federal health regulators to entrust Vermont with building a statewide system of coordinated care supported by payment reform known as the “All Payer Model.” It will be run by local health care providers — doctors, nurses, home care providers, social service workers and others — who have come together voluntarily to create an efficient system designed to make sure you have the support you need to be as healthy as possible. Health care decisions will still be made by you working with the providers you choose.
To bring about progress on making care more affordable, the model is designed to motivate providers to work together to eliminate waste and unnecessary treatment — such as duplicate tests — by setting limits on total spending. Requirements to meet rigorous quality measures will guarantee that patients do not receive less treatment than they need. It is a big step, but I believe we have an excellent chance to succeed because of the collaborative relationships that have developed within the provider community.
While there is uncertainty concerning the direction health care policy will take under a new federal administration, there are also many indications of bipartisan support for continuing on the path of improving quality, coordination and affordability.
A wide array of Vermont providers have worked closely over the past several years in a spirit of providing the best possible care for our fellow Vermonters. These relationships — built on trust and the shared belief that working together we can improve people’s lives — will see all of us through the uncertain, but also exciting, times that lay ahead.