Brattleboro Memorial Hospital (Zachary P. Stephens)
Wednesday August 1, 2012

BRATTLEBORO -- Brattleboro Memorial Hospital was able to keep its proposed 2013 budget below the threshold set by the Green Mountain Care Board, which will now go over every hospital budget in the state to determine spending plans for the coming year.

The Green Mountain Care Board, which was established to oversee most health care decisions in Vermont as the state attempts to make the transition to a single payer health care system, set a cap at 3.75 percent for the hospital budgets.

The net patient revenue at BMH is projected to rise by 3.2 percent next year.

"There were a lot of challenges this year but in the end we were able to make it work," said Michael Rogers, BMH vice president of Health System Finances. "Every year it gets harder and harder."

Revenues at BMH are projected to come in at just more than $130 million in 2013,

Rogers said BMH was challenged to keep spending down next year because volume is expected to increase by less than 2 percent.

He also said the hospital's push to open and operate more primary care practices puts a strain on the overall budget because those practices tend to lose money.

Rogers also said reduced Medicare payments continue to challenge the hospital to balance its books.

The hospital expects to trim its staff by 7.4 full-time positions, according to the proposed budget.

Rogers said the hospital projected a razor thin profit margin of less than 1 percent


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to keep costs down, but he said it would not be possible to continue too far into the future with such low projections.

In his letter to the state Rogers said, "If reimbursement levels decline further, this hospital will be unable to maintain a reasonable margin and that will ultimately challenge our continued existence."

Overall, the $2.1 billion in proposed budgets for the state's 14 hospital's was about 7 percent higher than the previous year so the board is going to have to make some unpopular decisions in the coming months if it wants to keep hospital spending down next year.

Vermont hospitals used to seek budget approval from the Vermont Department of Banking, Insurance, Securities and Health Care before the Green Mountain Care Board took over.

Mike Davis, director of cost containment for the Green Mountain Care Board, said the board is still determining how it is going to work with the hospitals.

BISHCA used to have representatives from each hospital give a presentation, but Davis said the process will probably be somewhat streamlined this year.

Davis was not sure if each hospital will be asked to give a presentation, or if only those with budgets above the threshold will be asked to explain their budgets.

"It's a new process and we are still sorting through how to proceed," Davis said.

The Green Mountain Care Board will be holding a public meeting over Vermont Interactive Television to talk about the hospital budgets at 1 p.m. on Aug. 14.

Howard Weiss-Tisman can be reached at hwtisman@reformer.com, or 802-254-2311 ext. 279. Follow Howard on Twitter @HowardReformer.