BRATTLEBORO — In a field as volatile as health care, it helps to have friends.
Brattleboro Memorial Hospital president and CEO Steve Gordon has cultivated many friends and allies for the hospital in Windham County, Montpelier, and in Washington, D.C.
That work has helped to strengthen the hospital's standing at a time when it seems every aspect of health care in Vermont is up in the air due to the Affordable Care Act on the federal level, and Green Mountain Care, Vermont's push to build a single-payer system.
Gordon recently received the 2014 American Hospital Association Grassroots Champions Award for exceptional leadership in generating grassroots and community activity in support of a hospital's mission.
Bea Grause, president and CEO of the Vermont Association of Hospital and Health Systems (VAHHS), said in a press release that Gordon “understands what it takes to create opportunity in his community, including federal advocacy.”
Gordon said advocacy is important, especially when it comes to the one federal program that is critical to the health of BMH - the Medicare Dependent Hospital Program.
“Sixty percent of our patients are covered by Medicare,” Gordon said in an interview last week. “That makes us a Medicare Dependent hospital, so we get an additional $2 million each year from the feds.”
The Medicare Dependent Hospital Program helps close the gap between the lower reimbursements that Medicare pays health care providers compared to private insurance.
“That $2 million is usually the difference in whether we finish a fiscal year in the red, or in the black,” said Gordon.
But that funding has been on shaky ground in Congress, and Gordon has worked with Vermont's congressional delegation - Sens. Bernie Sanders and Patrick Leahy and Rep. Peter Welch - to secure continued funding of the program for BMH.
“It keeps getting chopped and reinstated, so it makes budgeting really challenging,” said Gordon. “That's why we need to have a connection in Washington, and in Montpelier.”
Gordon says he also makes a point of regularly attending meetings of the Green Mountain Care Board, the panel tasked with creating Vermont's single payer health care system.
“I do that to make sure BMH is represented in the process,” he said. “We have the oldest population in the oldest state in the country. I don't want us to be forgotten.”
Dealing with uncertainty
Competition in the health care field is fierce right now, especially for small community hospitals such as BMH. The recent bankruptcy of nearby North Adams Regional Hospital in Massachusetts left a community of nearly 40,000 people without a hospital.
Could it happen in Brattleboro?
Gordon thinks not.
“What happened in North Adams didn't happen overnight,” said Gordon. “Their financial situation had been deteriorating for over a decade, and then they finally ran out of cash. BMH is in a stronger cash position, and our board is conservative when it comes to handling our finances.”
The difficulty for small hospitals to stay afloat is one reason why most of the hospitals in the Connecticut River Valley are affiliated with Dartmouth-Hitchcock Medical Center in Lebanon, N.H. It's the primary hospital to which BMH refers its patients.
“Dartmouth-Hitchock has to be a player in Vermont health care,” said Gordon. “They get 40 percent of their patients from Vermont.“
DHMC's role in a single-payer system in Vermont is still being determined, and there's talk that the Vermont single-payer system might evolve into a Northern New England network that includes New Hampshire and Maine.
That won't be easy, said Gordon.
“There's a much higher level of regulation in Vermont, and hospital budgets are more closely reviewed here compared to New Hampshire or even Massachusetts,” he said.
After his most recent visit to Washington to collect his award, he said he came away convinced that “not much is going to happen in Washington, so the pressure is going to be on us, and other states, to get health care reform done.”
“Fortunately,” he said, “Vermont is so far ahead of most states in health care reform. We have a really engaged legislative delegation, both in Montpelier and in Washington. Unfortunately, we're losing that spirit of compromise and give and take that we used to see in politics.”
Local support
Wooing the politicians in one thing; getting and keeping the community on your side is another.
Under Gordon's leadership, BMH recently completed its “Doorway to Exceptional Care” capital campaign to build a new $7.5 million Emergency Department. Gordon said it is almost fully operational, with a formal grand opening set for this summer.
“After three years [of being CEO], I am continually impressed by the level of support,” he said. “The Emergency Department campaign was as much about raising friends as raising money. The connections made with the whole community during this campaign were fantastic.”
Now that Vermont Yankee is closing, Gordon said the largest two employers in Windham County are now BMH (572 employees) and the Brattleboro Retreat (nearly 800 employees).
“Health care has become of big part of Windham County's economy,” said Gordon. “We have to make sure we have a sustainable, viable health care system here.”