Stephen Leffler: Academic medicine is essential to our state’s care

This comment was written by Dr. Stephen Leffler, president and director of operations at the University of Vermont Medical Center.

BlueCross BlueShield of Vermont, Vermont’s largest insurer, recently submitted a letter to the Green Mountain Care Board questioning the value of the University of Vermont Medical Center, Vermont’s only academic medical center. BCBSVT said our care has a lot of “bells and whistles”.

I’m not aware of the many ‘bells and whistles’ we offer at UVMMC. We try to provide good food for patients and their families, adequate parking and clean facilities. But mostly we focus on the excellent patient care that patients need, often to save their lives. I understand that our insurers can be very far from healthcare settings, and so the inherent value of high-quality close-to-home care may be lost on them.

If they had joined me last week for my weekly tours, health insurance executives would have witnessed the amazing, complex and comprehensive care being delivered at UVMMC. They would have watched the parents on our children’s floor anxiously waiting for their child to receive the life-saving cancer care available elsewhere in the state. Perhaps they would have met a patient who had just received a transcatheter aortic valve replacement, which is a complex, non-surgical heart surgery—our hospital is the only one in the state that offers this procedure. They may also have seen a trauma patient whose lifesaving care depends on Vermont’s only Level 1 trauma center.

UVMMC is the only hospital in Vermont where many life-saving procedures are performed. For these patients, the care we provide is not “bells and whistles,” but life and death.

On my weekly tours, I also meet medical students, residents, nursing students, and many other students who are learning and training at our Academic Medical Center. We have a shortage of doctors and health care providers in the United States – including Vermont. UVMMC provides a learning environment for future healthcare providers. Once they graduate, some of them remain in the state to contribute to our health care system. Last year, 28 physicians remained in Vermont to practice after completing their training. Recently, we recruited 150 nurses, many of whom graduated from the UVM Nursing Program. Local health care providers receive excellent training here and are our best bet for overcoming the workforce shortage that plagues all of American health care at the moment.

The University of Vermont Medical Center is regularly recognized as an excellent place to receive care. For the second year in a row, we received 5 stars from the Centers for Medicare and Medicaid Services. Only 15% of hospitals in the United States receive 5 stars. This arrangement takes into account many factors, such as patient experience, outcomes, and cost – in short, value.

In terms of cost, CMS says that standard procedures at UVMMC cost the same or less than the national average. Our Medicare spending per beneficiary is below Vermont and national averages. In fact, we are the least expensive Medicare academic medical center in the country.

These high ratings help us attract and retain world-class doctors, nurses and doctors.

Without an academic medical center, Vermont will send patients out of state for many specialized treatments and procedures, further complicating already existing challenges for accessing timely care. Besides the inherent risks, and the inconvenience (and sometimes the impossibility) of travel for the patient and their family members, it will also cost our state. Costs are often higher at out-of-state academic medical centers.

I am proud of the University of Vermont Medical Center. I am proud of the nearly 8,000 people who work here, all of whom carry out a unique mission of providing exceptional care to their neighbors, friends and family.

We have an amazing team of highly trained and dedicated people here to serve Vermonters. Our Academic Medical Center is a major component of Vermont’s health system. The work we do may sound like “bells and whistles” for the insurance provider, but for the patients who need us and the teams providing care, this is not a luxury but a care that is needed and expertly delivered. Vermont Academic Medical Center must remain strong, modern, and viable, so it’s ready when we or our loved ones need it.

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