RRMC has questions as it faces health reform
By Gordon Dritschilo
Staff Writer | June 20,2013
One of the main steps Rutland Regional Medical Center is taking to prepare for health care reform, according to CEO Tom Huebner, is asking hard questions.
“We see ourselves as a partner in reform,” he said Wednesday morning. “We believe reform is necessary.”
Huebner was addressing an audience of about 40 at a talk the hospital organized on the upcoming changes in the state.
“I guarantee you there are questions that you are going to come up with that I can’t answer,” he said. “There is enormous uncertainty, especially if you look out more than 12 months.”
Huebner said reform had two main goals. On the first, increasing access, he said Vermont already does well — the percentage of the population that is uninsured is less than half the national average and the state beats the national average on numerous health indicators. He attributed this to state actions like Catamount Health Care and increased Medicaid coverage.
On the second goal, containing costs, Huebner said Vermont has not fared as well. Vermont’s health care costs may be below the national average at the moment, he said, but they are accelerating at a much faster pace.
To slow that growth, the state is looking at changing how health care is paid for. Huebner said that while the current model relies on providers receiving fees for service, the field appears poised to move toward some sort of model where they are funded at a set rate in order to keep a population healthy.
That, Huebner said, is where the questions come in.
“These are new ideas, that are important ideas, but without a ton of on-the-ground experience,” he said. “They need to be piloted carefully.”
Huebner said the hospital is already participating in small-scale versions of such models. One is centered on congestive heart failure patients, who need a high level of care. Huebner said the approach has led to a level of coordination among providers that cut those patients’ re-admission rates in half. This, in turn, cut costs.
Huebner said he was worried about a discussion of reducing the rate at which providers are reimbursed from 129.7 percent of Medicaid’s rate to 105 percent. He said that would cut RRMC’s budget by $44 million.
“I can tell you right now that would not sustain something that looks like Rutland Regional Medical Center,” he said.
Huebner also noted that the less Vermont pays providers, the harder it will be to attract them.
“If you start paying people well below market, New Jersey starts looking better,” he said. “Access becomes an illusion. You could have access to insurance and no one to take care of you.”
All that said, Huebner said the hospital was committed to the reform process because, ultimately, its mission is to sustain the health of the community.
“We do not believe the status quo is sustainable,” he said. “We do not. While I want to ask hard questions, we do not believe you can stay still.”