As UVM Health Network cuts services in Vermont, it expands in New York  – VTDigger

Last month, the University of Vermont Health Network announced a slate of wide-ranging cuts to its Vermont facilities. 

Those cuts — which drew a swift and furious outcry — included closing an inpatient psychiatric unit at Central Vermont Medical Center, ending kidney transplants at the University of Vermont Medical Center, and shuttering a primary care clinic in Waitsfield. 

Across Lake Champlain, however, the situation looks very different. Over the past few years, UVM Health Network’s facilities in northern New York have added capacity and increased the volume of certain procedures.

Over the past two years, Champlain Valley Physicians Hospital, in Plattsburgh, has worked to increase the number of surgeries it performs, according to Annie Mackin, a network spokesperson. During that time, Elizabethtown Community Hospital’s Ticonderoga campus has expanded clinics in women’s health and dermatology. Late in 2023, a primary care clinic operated by another health care organization opened at Alice Hyde Medical Center, in Malone. And earlier this year, Alice Hyde hired a general surgeon, the network announced in October. 

The network hopes to add even more capacity in the state in the coming years, leaders say. 

“In New York, we’re doing our very best to expand services, to grow opportunities, to be able to have more opportunities to see patients over there,” Steven Leffler, president and chief operating officer of UVM Medical Center, said in an interview last month. 

“We’re hoping they’ll have more inpatient access to cover patients who can’t stay here,” Leffler said, referring to the Burlington hospital. “We’re hoping we can move more surgical cases there as a way to make sure that access is maintained for people who may have, unfortunately, more (of a) challenge getting access here.”

‘Patient-centered and patient-focused’

Leaders of the six-hospital network said the additions in New York are simply part of ongoing efforts to help patients access more care more easily — similar to what the network seeks to do in Vermont. 

The University of Vermont Medical Center, Central Vermont Medical Center and Porter Medical Center, in Middlebury, are all part of the UVM Health Network.

The recent cuts on this side of the lake, administrators say, were due solely to the actions of the Green Mountain Care Board, a state regulator that capped network hospital budgets and ordered UVM Medical Center to reduce its charges to private health insurers earlier this year.

Additions at New York hospitals, which are not under the board’s jurisdiction, have nothing to do with the board’s orders and often predate them, network leaders said. 

That work “is totally independent and unrelated to regulatory action here,” Sunny Eappen, the president and CEO of UVM Health Network, said in an interview.

Expanding services in New York, however, does benefit Vermont’s hospitals. In the 2023 fiscal year, New York residents contributed roughly 14% of the University of Vermont Medical Center’s patient revenue, to the tune of $245 million, according to financial documents submitted to the Green Mountain Care Board.

In Vermont, the care board places limits on how much hospitals can bring in from patient care — limits that UVM Health Network officials have said are onerous and harmful. By adding capacity in New York, the network can keep some of those patients in their communities and out of Vermont hospitals. 

Owen Foster, the chair of the Green Mountain Care Board, declined to comment, saying he did not know the details of the network’s New York hospital services. 

In 2025, Champlain Valley Physicians Hospital plans to add operating room capacity for general surgery, urology, ear nose and throat procedures and orthopedics, according to Mackin, the network spokesperson. The network has invested in some “anesthesiology resources” for that expansion and is recruiting urology and orthopedics clinicians, she said.

The network has also informed about 370 New York patients that they have the option of getting imaging procedures — such as x-rays — in-state, rather than in Vermont, Mackin said. UVM Health Network is also “evaluating opportunities” to add gastroenterology, cardiology and infusion procedures in New York, she said. 

“It’s patient-focused and patient-centered, right?” Lisa Mark, the chief medical officer of Champlain Valley Physicians Hospital and Alice Hyde Medical Center, said in an interview. “So they don’t have to travel across the lake if they don’t need to.”

Vermont and New York

Over the past few months, UVM Health Network has drawn scrutiny for the movement of money between its Vermont and New York hospitals.

That attention was sparked by the revelation, during the Green Mountain Care Board’s annual hospital budget review process, that Burlington’s UVM Medical Center was owed $60 million by Champlain Valley Physicians Hospital in Plattsburgh.

That has led to fears that Vermonters are subsidizing New York medical facilities. In comments submitted to the Green Mountain Care Board in August, Vermont’s chief health care advocate Mike Fisher and his staff members charged that the network “has consistently weakened its financial position by choosing to transfer monies to the New York hospitals.”

Network leaders have repeatedly denied that those transfers — which have paid for pharmaceuticals, physicians’ salaries and other expenses — had any impact on Vermonters. Those transfers affect a hospital’s cash on hand, leaders said, but do not affect margins or Vermonters’ commercial insurance rates.

“We’ve been very, very clear on that,” Rick Vincent, the network’s executive vice president and chief financial officer, said in an interview. “The Vermont commercial rates are not impacted by those New York hospitals.”

Last month, the care board asked the network for more information about the New York hospitals’ finances, including their operating margins and cash on hand. 

UVM Health Network initially declined to provide that information. But Eappen said in an interview he does intend to share the hospitals’ financial information with the board. 

According to publicly available nonprofit tax forms, some of the network’s New York hospitals have struggled in the past years. Champlain Valley Physicians Hospital lost nearly $30 million in its 2022 fiscal year and nearly $40 million in the 2023 fiscal year, according to tax records, and Alice Hyde Medical Center lost about $20 million in those two years, as well. Elizabethtown Community Hospital, meanwhile, has reported positive margins for the past decade.

Eappen said that Champlain Valley and Alice Hyde have grown more stable in the past year, although financial data is not yet publicly available.

There are “not yet” plans to shift more services to New York as a result of the Green Mountain Care Board’s orders, Eappen said. But keeping care close to home for residents of northern New York is a win-win, he said. 

“If New Yorkers stay in New York, it doesn’t contribute to that Vermont revenue piece,” Eappen said, referring to patient revenue, which is capped by the Green Mountain Care Board. “And so if we do it well and keep New Yorkers in New York, it’s a positive on both ends.”