Vermont hospitals say aging, higher-acuity patients and workforce costs are straining system; propose talent pipelines, bed-capacity tool and interoperability

Devin Green, government relations at the Vermont Association of Hospitals and Health Systems, told the House Healthcare Committee on Jan. 15 that Vermont hospitals are facing rising patient acuity, workforce costs and regulatory constraints that together threaten system sustainability.

Green said the state's rural geography and an aging population have made it harder to get patients "to the right care at the right time," and that hospitals are seeing both higher case-mix indexes and longer lengths of stay. "Vermont's landscape is rural and aging," she said.

The association's presentation said Vermont has 16 nonprofit hospitals, including eight critical-access hospitals and one academic tertiary center (University of Vermont Medical Center). Green said the state also has five inpatient psychiatric units located inside hospitals, one freestanding psychiatric facility (Brattleboro Retreat) and a VA hospital.

Why it matters: Hospitals represent about half of Vermont's health-care spending, Green said, and many of the state's affordability and access problems are interconnected across hospitals, home- and community-based providers and behavioral-health services. Green told lawmakers that cuts in other parts of the system (home health, mental…