As we begin a new year, and as I embark on my second year as CEO of the University of Vermont Health Network, I feel a sense of both optimism and urgency.

Optimism, because I think we have an opportunity to make progress on the challenges we share in this region – if we work together. And urgency, because we need to act now to ensure we are best serving our patients and communities, today and into the future.

So I want to offer some important updates on where the UVM Health Network stands, and also to ask for help in making our communities in Vermont and the North Country of New York as healthy, vibrant and sustainable as they can be.

I’ve done a lot of listening and learning in my first year as CEO, and that has shaped four fundamental “pillars” we’re focusing on for our health system:

We want to create an exceptional UVM Health Network experience for our patients and everyone who works for the health system.

We’re prioritizing education and research. Our academic health system is making, and needs to continue to make, a real difference across Vermont and in the North Country of New York.

Stewardship of our communities is about community health, and building public trust and confidence in our health system.

We also need to achieve operational excellence and financial sustainability to fulfill our mission.

That’s where we’re headed, but we face the same challenges that many people in this region are dealing with in their daily life and work – things like inflation, labor costs, workforce shortages and a lack of housing and childcare.

The landscape of providing health care services in a rural setting has shifted. And these challenges have made it much harder for our not-for-profit health system to achieve the margin we need to make investments in our people and in the quality of the health care we provide.

In our fiscal year that ended September 30, we achieved a razor-slim margin, but fell short of our goal by $47 million. In our current fiscal year, we’re working to close a $75 million gap that resulted from number of factors, including the decision by our Vermont regulator, the Green Mountain Care Board, to significantly cut our budget.

The fact is, if we hadn’t received one-time relief funds, the UVM Health Network would have lost hundreds of millions of dollars since 2020. This is not sustainable.

So we’re engaged in a difficult balancing act: We’re working to improve patient access and moving toward a value-based, population health management system, while also operating more efficiently and creating new sources of revenue.

For example, we’re prioritizing access to surgical services at several hospitals, which addresses patient wait times while increasing revenue. We’re improving efficiency for providers and patients – things like expanding eConsult services between physicians; launching self-scheduling for patients in MyChart; and additional measures to reduce the amount of time patients stay in the hospital unnecessarily.

We’re also cutting costs: For example, we’ve reduced expenses by $20 million, including eliminating 130 open positions, in shared administrative services that support organizations throughout our health system. And we’re continuing to closely scrutinize all new hiring.

These kinds of cuts create additional obstacles, because we know they have an impact on our people and on our patient-care and patient-experience initiatives.

If we choose to act collectively – as members of our communities, and as a region – we can make real strides in overcoming our shared challenges. Here are some key areas where we need partnership:

Economic development and growth – We need more residents, more people in the workforce, more businesses. This can happen only through a coordinated, all-out effort that involves government and the private sector. The UVM Health Network is ready to be a partner in this charge.

Housing – We’ve started to invest in housing for our workforce, but it’s a drop in the bucket compared to what’s needed in our region. We need more, better and smarter housing solutions.

Finances – The health care affordability crisis affects everyone, and it’s going to take a collective effort to change it. We’re cutting costs and finding new revenues where we can, while limiting impacts on access to care. And we’re pushing hard for a better clinical and financial system that rewards wellness and care outside the hospital. But we need more voices calling for meaningful health care reform; realistic reimbursement from Medicare and Medicaid; and a fair and consistent regulatory environment that helps us meet our mission.

We all share a common interest in the vitality of our communities. That presents a great opportunity to work together.

We have everything to gain, and we know what’s at stake: It’s the future of this region, and the quality of life for our children and grandchildren.

Note: Sunil “Sunny” Eappen, MD, MBA, is the president and CEO of the University of Vermont Health Network. He has more than three decades of experience in health care, including clinical, leadership and academic positions. Porter Hospital in Middlebury is part of UVMHN.