I am raising concerns about the conduct, governance, and board leadership at UVM Health Network and its Vermont hospital network, which includes Porter Medical Center, Central Vermont Medical Center, and UVM Medical Center. As a nonprofit organization, their focus should be on serving the best interests of their patients and healthcare professionals, but instead, they are prioritizing competition, market consolidation, and revenue generation. This goes against the important mission of population health. I have experience in nonprofit governance and understand that nonprofit organizations should work together to amplify their mission’s impact, rather than competing with each other.
During my time as chairman of Fletcher Allen Healthcare, the predecessor of UVM Medical Center Hospital, I witnessed unethical behavior, including lying to regulators. Despite knowing about the organization’s criminal intent, I agreed to take on a leadership role. I have always believed that our hospitals are successful in terms of clinical quality but fall short when it comes to access and affordability. It is the responsibility of healthcare boards, including UVM Health Network and UVM Medical Center, to ensure that the mission is fulfilled and that ethical and financial integrity is maintained.
Unfortunately, the decisions and actions of the current UVMHN and UVMMC board are questionable in fulfilling their duties. The recently retired President, Dr. John Blumsted, received over $2 million in compensation in his final year, and the combined income of administrative staff who do not directly impact clinical care is $13.9 million. These excessive salaries raise concerns about the organization’s priorities. OneCareVT, an accountable care organization under the control of UVM Health Network, has asked for a reduction in executive compensation, but the appeal is still ongoing.
A concerning decision was made by five key hospital board members within the network. They contacted legislative leaders ahead of a rate request, which raises questions about the integrity of the Green Mountain Care Committee. It seems the intention was to influence the decision-making process before it even took place. The role of governance is to ensure mission execution, ethical integrity, financial integrity, and executive leadership competency, not to create the budget.
Furthermore, there have been attempts to discredit three new members of the Green Mountain Care Committee, Dr. David Mirman, Owen Foster, and Tom Walsh, questioning their medical skills and experience. This is unfair, as they have more experience than some of the UVM Health Network governing board members who raised these concerns. Dr. Mirman has been pressured by UVM Network, despite his ethical obligation to act in the best interest of Vermonters’ health. He has appropriately distanced himself from budget decisions regarding his own hospitals but still faces undue pressure.
The proposed budget by UVM Health Network includes significant rate demands and large increases in hospital budgets, far exceeding medical inflation and cost estimates reported by insurance companies in other states. These increases are not sustainable and will lead to a significant burden on patients and healthcare systems. From 2000 to 2018, the annual growth rate in healthcare costs in Vermont was 9.3%, and from 2018 to 2020, net patient revenue increased significantly.
It is clear that there are serious ethical concerns regarding the conduct, governance, and board leadership at UVM Health Network and its Vermont hospital network. Their actions prioritize competition and revenue over the mission of population health, and their excessive salaries and rate demands are unjustifiable. Changes need to be made to ensure that the focus is on serving patients and healthcare professionals, and that access and affordability are prioritized.