Online Exclusive Questions

Health care is a local game. What can you say about the unique circumstances of UVMC’s market that may have influenced your decision?

BRUMSTED: Well, I would say two things. One is, to which I just alluded, the regulatory environment in our market, which is primarily Vermont but also significantly in northern New York state, is moving toward value-based payments. The second is that, traditionally, we have been an efficient, low-cost and high-quality academic medical center, so we feel that we can move into more of a fixed revenue environment and do quite well.

What has UVM found to be the most essential skills or tools to be prepared for value-based care?

BRUMSTED: A high degree of clinical coordination and integration and, to do that around populations of patients, I think that is absolutely at the top of the list. That’s much easier to do within a network of providers that have a corporate relationship, like the University of Vermont health network, than it is in a looser affiliation like an accountable care organizations network. But we’ve found great traction in that. And the second is to really invest in the expertise of the people. Financial expertise, operational expertise, clinical expertise, experience in managed care environments — and we’ve done that as well.