UVM Health Network revamps governance structure

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The organizations that make up the University of Vermont Health Network have made changes to their board governance structure to enable deeper health system integration, support the network’s ability to become more agile and strengthen alignment with its mission centered on population health.

The UVM Health Network is made up of an anchor academic medical center in Burlington, five community hospitals, a children’s hospital, a group of multi-specialty physicians and a home health agency, all governed by separate boards that ultimately report to the network board. Compared to many systems across the United States that include dozens or even hundreds of hospitals, the nonprofit UVM Health Network is relatively small and seeks to make the most of what it means to be a system integrated rural health system.

Like many hospital systems, UVM Health Network is facing a severe financial crisis. Citing inflation and staffing issues caused by the pandemic, the network is asking Green Mountain Care Board regulators for a 19.9% ​​increase in commercial insurance fees in 2023 for the University of Vermont, a 14.52% increase for Central Vermont Medical Center and an 11.45% increase. for Porter Hospital.

In its budget proposal, the Network stated that “in recent years, we have not been entitled to rate increases that keep pace with cost inflation. This has eroded our already thin margins, forced us to dip into reserves to meet spending needs, and undermined the sustainability of the health services we provide.

One of the ways the Network is trying to solve its financial viability problems is to reorganize itself. Feedback from all affiliated boards and a review of more mature health systems approaches in the North East led to the decision to streamline and redesign the network’s governance structure to more fully integrate decision-making. decision and operations. With the approval of all Affiliate Boards, this restructuring will now continue.

Following votes in favor of the changes by the boards of directors of each of the network’s six hospitals and home health agency, the UVM Health Network Board of Directors voted to pass changes that align stronger local Affiliate Board oversight of community-focused areas, including local population health initiatives; quality of health care; diversity, equity and inclusion; and philanthropy. To support this effort, key governance oversight functions – such as finance, budgeting and strategic planning – have been transferred to the network’s Board of Directors.

“The UVM Health Network exists to preserve access to high quality care in the communities we are privileged to serve. These changes will help our organizations across Vermont and northern New York work together more effectively as we make key decisions and guide initiatives that improve quality of care and the overall patient experience,” said Allie Stickney. , chair of the UVM Health Network Board of Directors, in a statement.

Affiliate Boards will continue to maintain their current size, and Affiliate Board members will participate in key operational decisions, with representation on critical network board committees that carry out this work, the Board said. network.

In its budget request for 2023, the Network outlined other ways to pursue greater integration. “We are making the necessary investments in the integration and sustainability of our network through the addition of key leadership positions, including a Chief Nursing Officer (CNO), a Chief Medical Officer (CMO) and a Chief Diversity and inclusion (CDIO). The CNO and CMO are central to our efforts to standardize and better coordinate care across the Network. The CDIO is responsible for implementing our network-wide DEI strategy.

In fiscal 2022, the network continued to implement centralized IT platform services and applications across the UVM Health Network. Applications include Electronic Health Record (Epic), Supply Chain (Premier Connect), Human Resources (Workday), Cardiology Imaging (Merge), Radiology (Visage) and other clinical systems, d infrastructure and commercial. “This work is an investment in improving efficiency, reducing costs, improving staff satisfaction and, most importantly, standardizing and improving patient care,” the network said. .

The Network also deploys a regional transport system, which manages the transport of patients between care facilities and the coordination of care, and the regional assignment of health care providers to make care accessible even if they are not located in a specific community.

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