BENNINGTON -- About 70 physicians at Southwestern Vermont Health Care are now employed by Dartmouth-Hitchcock.

Patients going to Southwestern Vermont Medical Center will not notice much of a difference, according to SVHC President and CEO Thomas Dee, who added that affiliation and service agreements were signed between the two health care groups on July 1. The hospital had announced some months ago that the move was being negotiated.

Previously, SVHC employed a number of physicians to be part of its medical group, which was overseen by a chief medical officer, said Dr. Mark Donavan, chief medical officer for the new medical group, called Dartmouth-Hitchcock Putnam Physicians. By having its doctors employed through New Hampshire-based Dartmouth-Hitchcock, SVHC hopes to become more attractive to physicians.

Hospital officials have long said that the high cost of running a medical practice and low reimbursements on government insurance programs have made it difficult for privately run practices to survive in rural areas.

Dee said that in the past 60 days, SVHC's connection to Dartmouth-Hitchock has already netted it two doctors he doesn't think the hospital would have otherwise been able to attract.

John Butterly, executive vice president for medical affairs for Dartmouth-Hitchock, said his organization benefits because of how insurance reimbursements are expected to change. He said the pay-per-service model will likely fall by the wayside and give way to hospitals


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being paid based on the number of patients in their communities, thus encouraging them to keep populations healthy rather than move a certain number of patients though the medical system. He said Dartmouth-Hitchock will benefit by increasing the size of its patient base.

Dee said the affiliation agreement and service agreement are both in effect for three years. The medical group is overseen by representatives from both health care groups in terms of recruitment, while the SVHC Board of Trustees retains oversight responsibility for them. While a few administrative positions will shift to Dartmouth-Hitchock, most who handle billing and similar functions will remain SVHC employees.

Another benefit from being with Dartmouth-Hitchock, Dee said, is that SVHC will have access to the group's technical skills and specialists. Dartmouth-Hitchock has one of the largest specialist groups in New England, employing more than 1,000 physicians. Dee said Dartmouth-Hitchock is also well versed in anticipating changes to health care coverage, which is now expected in Vermont. He said about 40 percent of Dartmouth-Hitchock's patients are Vermonters, and the group has been factored into proposed changes to the state's health care system.

Dee said while SVHC doctors will be employed by Dartmouth-Hitchock, they will work in Vermont and subject to the state's rules and regulations.

When SVHC announced it was talking to Dartmouth-Hitchock about a possible affiliation, it said it also looked at Fletcher-Allen Health Care in Burlington, and Albany Medical Center in New York. Dee said Dartmouth-Hitchock was chosen because it viewed health care in the same way as the local group.

Donavan said Albany Medical Center will retain its close ties to SVHC. The Albany center has a helicopter service and advanced trauma units, along with other emergency services. People who suffer severe injuries in the Bennington area are often taken there.

Butterly said this will not affect the amount of referrals SVMC makes to Dartmouth-Hitchock, which is about a two-hour drive away. He said the distance makes such a practice impractical, and even if it were, it is not a good enough reason to affiliate.

"This is not a merger or a takeover," Dee said. "No assets or cash are changing hands. SVMC will continue to operate our medical practices. The major difference patients may notice is that the doctor they're seeing is now a part of Dartmouth-Hitchcock."