Kniffin, Brumsted cite advantages for Porter Hospital/UVM affiliation

MIDDLEBURY — University of Vermont Medical Center CEO Dr. John Brumsted took UVM Health Network’s ongoing courtship of Porter Hospital directly to area residents on Thursday, saying such a marriage would improve services for the Addison County community.
Brumsted and Porter Medical Center CEO Dr. Fred Kniffin took center stage at a community meeting at Middlebury College’s Kirk Alumni Center, during which they shared the potential benefits of PMC’s affiliation with UVM Health Network — a coalition of five medical institutions in Vermont and New York state. The duo spent most of the almost two-hour gathering fielding questions from a crowd of more than 120 people who wanted to know how the proposed partnership might affect local hospital services, nursing home care, area medical practices and the livelihoods of the more than 800 Porter employees.
An affiliation with UVMHN — which could be formalized as soon as this spring — would net Porter a new medical office building of 40,000 to 50,000 square feet, a new state-of-the-art electronic medical records system, access to more specialized care for Addison County patients, a wider net for recruiting health care providers, more budget stability, and more effective purchasing power for equipment, supplies and employee benefits, Kniffin and Brumsted said on Thursday.
The University of Vermont Health Network already includes UVM Medical Center in Burlington; Alice Hyde Medical Center in Malone, N.Y.; Central Vermont Medical Center in Berlin; Champlain Valley Physicians Hospital in Plattsburgh, N.Y.; and Elizabethtown (N.Y.) Community Hospital. It boasted a combined staffing in 2015 of 1,188 physicians, 2,783 registered nurses, and a total of 7,995 employees.
Kniffin said a partnership is not expected to result in the closing or sale of Helen Porter Healthcare & Rehabilitation (the nursing home), any layoffs at Porter Medical Center, or the sacrifice of any of Porter’s core services. Porter will also keep all of its current assets, according to Kniffin. And independent provider practices in Addison County — such as Rainbow Pediatrics and Middlebury Family Health — would continue to enjoy open access to Porter facilities, officials said.
On the other hand, Porter would lose its more than 90-year-old status as an independent community hospital.
“We would lose some autonomy,” Kniffin acknowledged.
For example, while PMC would maintain a local board of directors, the UVMHN board — on which Porter would have representation — would make final decisions on the annual budget and major capital purchases.
Porter medical staff would remain employed by PMC for a period of 18 months, at which time they would switch to a network-wide UVM medical group. All other PMC employees would remain Porter workers.
Brumsted noted many Addison County patients already enjoy a close relationship with both Porter and the UVM Medical Center. In 2015, half of the patients who received services from a Porter physician also received services from a UVM Medical Center-affiliated physician, according to Brumsted.
“There is so much overlap already in the care that’s provided that by being separate, we’re leaving a lot on the table that we could do a lot better,” Brumsted said. “I believe you are already providing great service to the Porter community … but just think of what we could bring to bear if we are working together.”
As recently reported in the Independent, the collaborative process between the two entities began earlier this month, when Dr. Diana Barnard — a UVM Medical Center employee — started providing palliative care services at Porter Medical Center.
“That’s just one example of the power of collaboration,” Brumsted said.
He confirmed Porter would receive UVM Medical School residents, if affiliation goes through.
“It’s something we view as incredibly important,” he said.
Brumsted voiced enthusiastic support for the capital upgrades Porter is seeking through affiliation. He called the office building request “in our sweet spot,” and acknowledged the need for Porter to be part of the same EPIC electronic medical records platform as the other UVMHN members.
“It speaks to the fact that we view the world very similarly and have the same motivations,” Brumsted said.
“Just think of what we can bring to bear if we work together.”
Kniffin said affiliation could result in more hiring at Porter due to increasing services, rather than a reduction in force created by economies of scale.
“We don’t expect layoffs,” Kniffin said. “We don’t see how our services would change to create layoffs.”
Middlebury Selectwoman Laura Asermily — who chairs the town’s Health & Public Safety Committee — asked if affiliation might improve services for mental health patients and those recovering from drug addiction.
Brumsted replied collaboration will only help improve programs for what he called a “vulnerable population,” but he said it will take a public-private partnership to tackle the issue.
“(The state) has underfunded other components of the mental health system, and we are at a breaking point,” Brumsted said.
“Whatever we are doing now, it’s not working.”
He said the Burlington area has been making gains in the battle against drug addiction by assigning patients a treatment — such as Suboxone — prior to them being assigned a primary care provider. This way, the patients are better prepared to tackle their recovery regimen, he said.
“I believe we can do that in Addison County, as well,” Brumsted said.
Some participants at Thursday’s meeting asked Brumsted if he thought affiliation would result in more Addison County patients heading to Chittenden County for specialty care. He noted that since Central Vermont Hospital joined UVMHN, fewer Washington County patients have been traveling to UVM Medical Center. He would expect a similar trend in Addison County.
“If you can provide the services locally, you should,” Brumsted said.
Weybridge resident George Bellerose asked how UVMHN is preparing for potential sweeping changes in federal health care legislation. President Donald Trump has vowed to repeal the Affordable Care Act.
Brumsted said UVMHN affiliates are waiting to see how the health care battle is decided in Washington before implementing changes to operations.
“Something is going to happen there so the powers that be can declare ‘victory,’” Brumsted said.
“We are watching very carefully for real changes,” he added. “What we’re not doing is changing our core strategies and our approach — improve the health of the population, improve the patient experience and reduce health care costs. We work really, really hard on those.”
Kniffin was asked about the future of the nursing home, which he acknowledged has been struggling financially. Helen Porter lost $2 million last year. He stressed it will be essential for the facility to increase the number of rehabilitation cases it sees each year, as “that is what makes the money.”
Porter employees would likely not be elevated to the UVM Medical Center pay scale if affiliation goes through, Kniffin said, though their benefits package could improve through the larger UVMHN bargaining power.
“We would hope they would gain some advantages over the long run,” he said of Porter employees.
Officials will now return to the negotiating table in hopes of forging an affiliation deal by April.
“We have got to get this right,” Kniffin said.
Reporter John Flowers is at [email protected].

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