Vt. hospitals to present proposed budgets to regulators

MONTPELIER — Vermont's 14 hospitals will be presenting their proposed budgets to regulators in public hearings starting this week.

The Green Mountain Care Board is doing its yearly review of the spending plans.

The board will hold hearings this week and next in Montpelier, Burlington and Castleton on budgets for fiscal year 2019.

"It's a chance for the hospitals to present their story," Board Chairman Kevin Mullin said Friday. "The hospitals keep saying that each hospital is a different institution and there's some validity to that." It's also a chance for the board and health care advocate to ask questions and the public to weigh in.

The board has set a target increase of 2.8 percent in what hospitals are paid for their health care services and a .04 percent increase for investments in health care reform. As a group, the hospitals are coming in below the total percentage increase at 2.9 percent but many of the smaller hospitals individually are not, Mullin said.

"That's what we have to get to the bottom of. The reason why," he said. "The hospitals would like to paint the picture that overall the hospitals have come in under budget but if you take a look at it, it's all over the map. "Fortunately those hospitals that are larger are treating more Vermont patients (and) were able to come under the 3.2 (percent) cap. But smaller hospitals are pretty much saying that they can't. That's the story that we're going to have to listen to and make a decision on."

In setting budgets, it's less about the size of the hospital, than the characteristics of the individual hospital and the health care needs of the community, said Jeff Tieman, president and CEO of the Vermont Association of Hospitals and Health Systems.

Rural hospitals, which are often small, face challenges nationwide, he said. The challenge for smaller hospitals is they don't have as many economies of scale as larger ones, he said.

"A good way to think of it is a 1 percentage increase for a big hospital yields quite a bit more money than a 1 percentage point in a smaller hospital, even though they're faced with many of the same challenges and demands, from labor costs to high drug costs to supply chain challenges," he said.

The board plans to issue decisions on the budgets in mid-September.


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