UVM Health Network Reacts to VHC911's Data
VHC911 – Stat v.3
UVMMC is among the most expensive Academic Medical Centers in the country, and it is not unique in serving both as a tertiary and community hospital.
UVMMC’s recent statement fails to rebut our data demonstrating excessive costs. Wednesday's Burlington Free Press highlighted VHC911's findings that the University of Vermont's Medical Center is losing $119.4M annually treating Medicare patients. The loss on Medicare is made up by inflating rates charged to commercial insurance and helps explain why insurance in Vermont is the most expensive in the nation.
The Free Press story includes a response from the University of Vermont's parent corporation, the University of Vermont Health Network (UVMHC) whose Chief Media Relations Officer Annie Mackin offered their perspective.
UVMMC does not refute the fact they are the 6th worst-performing Academic Medical Center (AMC) in terms of Medicare losses. Instead, Ms. Mackin repeats a few claims we have heard repeatedly over the years.
"UVM Health Network Chief Media Relations Officer Annie Mackin said it's important to keep in mind that Vermont has one of the lowest costs per Medicare beneficiary of any state in the country...'This shows that we are clinically efficient and not performing unnecessary services, but it does also mean that we take in less Medicare revenue than many health care providers in other states,' Mackin said."
While Vermonters may have a low total health care cost per Medicare beneficiary, national data suggests that this is despite a high cost for services at UVMMC as compared to 106 other AMCs.
In fact, the cost for each Medicare patient discharge at UVMMC is the 17th highest among these AMCs and is higher than many other AMCs in the Northeast and Midwest including Dartmouth Hitchcock, Maine Medical, Albany Medical Center, Rhode Island Medical Center, Yale Medical Center, UMASS Medical Center, Mass General Medical Center, University of Cleveland Medical Center, Cleveland Clinic, and Geisinger Medical Center.
VHC911 does not dispute that UVMMC and Vermont's other hospitals strive to be clinically efficient when caring for Medicare beneficiaries and we applaud the incredible job Vermont’s healthcare providers do. However, that fact doesn't obscure the financial reality that UVMMC is not operating as cost effectively as other AMCs. And the financial loss they report for each Medicare discharge drives Vermont's commercial insurance rates higher.
UVMHN also falls back on an excuse we have seen many times: that UVMMC is somehow unique.
"'Many other academic medical centers (such as Dartmouth) are located in rural areas as defined by CMS (Centers for Medicare & Medicaid Services), qualifying for additional Medicare reimbursement, but UVM Medical Center is located in a CMS-designated 'urban' area,' she [Mackin] said."
"...unlike many other academic medical centers, UVM Medical Center is both the region's academic medical center and its local community hospital, providing the lower-acuity services patients need from a community hospital, which 'essentially dilutes the overall payments we receive from Medicare.'"
It is true that Medicare pays AMCs in urban areas a lower rate than those in rural areas. But most AMCs are in cities and over 75% of them break even treating Medicare patients.
Furthermore, Mackin and UVMHC leadership would have us believe that providing "lower-acuity services" - think primary care and out-patient services - is also a unique feature at UVMMC. That is simply not true.
AMCs across the country deliver a full array of healthcare services in the communities and regions they serve, including at multiple sites that offer specialty and primary care. Many provide lower acuity care to a mix of urban, suburban, and rural settings. For example, the University of Colorado Health System delivers care through a network of hospitals, clinic locations and health care providers throughout Colorado, southern Wyoming and western Nebraska.
The University of Arkansas Health System includes its central campus along with clinics in all 75 counties in the state, eight regional family medical centers, eight Centers on Aging, and one of the most successful Head Start Programs in the nation.
Closer to home, the Albany Medical Health System includes the Albany Medical Center as well as other hospitals and a wide array of health services in clinics that stretch from the Hudson Valley to the North County of New York.
These AMCs all perform better on Medicare reimbursement than UVMMC and deliver the same type of community care that UVMMC claims as a distinguishing characteristic.
In fact, out of the 106 other AMCs included in the comparison with UVMMC, it is difficult to identify one that doesn't provide a range of acuity services across the communities they serve. And it is easy to find many that do this across both urban and rural regions. What is different is that 82 (77%) of 107 of these AMCs break even or make a profit on Medicare reimbursement, and that UVMMC reports the 6th highest loss on Medicare reimbursement.
VHC911 is dedicated to presenting Vermonters and our leaders with data to help our state get control over the high cost of healthcare. We will do our best to offer clarity about the many opportunities we have to save money while protecting health services.