A Message from the Administrator

The following is an excerpt from our 2013 Annual Report: A Recipe for Success.

Joe Woodin

Joe Woodin

This has been another successful year for Gifford, and it is due to our continued ability to take care of so many different patients, from so many different communities. Ultimately that is our mission and focus, and for me constitutes our Recipe for Success. We continue to offer treatment and services over a wide geography, and “how” we do that is as important as “what” we do. We strive to bring personal attention into the clinical delivery system through relationships and flexibility. Sometimes we do these things very well, and sometimes we learn and grow from our experiences and shortcomings. In all instances we are indebted to the many communities and friends who utilize us and give us feedback and support.

A Gallon of Leadership

A Gallon of Leadership

This has also been a year marked with stress over health care reform and the roll-out of both a national and state-wide insurance product (i.e. Vermont Health Connect). Although the state has done a better job than the federal government in implementing the insurance exchange, there is still much uncertainly about these new programs, with people looking for answers and assurance that this is the “right direction.” That uncertainty, however, does not find its way into our planning for the future. Gifford has always relied upon a simple understanding that if we focus on patient care, quality and insuring access to everyone, regardless of their ability to pay, we will be successful. Maybe it’s that three-ingredient recipe that has helped sustain us over these past 110 years (since our founding in 1903). While others are employing sophisticated forecasting techniques and prediction models, we are just trying our best to be your medical home and guide.

I hope you enjoy this report, and the many stories that highlight our efforts this past year. We are grateful for the legacy we have inherited, and continue to build upon that
success each and every year.

Joseph Woodin

A Message from the Administrator

Joe WoodinGifford Administrator Joe Woodin wrote the following as an introduction to the 2012 Annual Report, segments of which we’ll be featuring on our blog:

It’s interesting to be working in an industry that continues to be under the microscope of the political process, with people wanting more control over the cost of health care. Frankly it can be a bit exhausting, but I can understand and agree with their concerns.

“What can we afford?” is becoming an uncomfortable theme both locally and nationally; although we can all relate to this in our daily lives when we go shopping for food or services. There are now so many involved in helping to “fix” the health care system that it becomes a daunting task just to stay focused on the basics: providing quality patient care with compassion and kindness.

This report highlights a few of our providers who have remained focused and undistracted by all of the changes in health care. As the years have ticked by, they have not lost their love of the profession, nor have they been dissuaded by all of the changes, paperwork, and new requirements. Their work has become a calling, and they have touched many of our lives when we have been in need of medical help.

The more we try to understand and solve the complicated aspects of health care, the more I am reminded that at the end of the day, there are still patients in beds or in clinic exam rooms awaiting care. They are usually anxious, at times scared or upset, and always hopeful that someone can give them answers and help them through the next step. Our role is to ensure that we have a provider willing to enter into patients’ lives, helping to answer questions and even hold their hand when the news is “not good”.

So regardless of where we end up with “health care reform”, hopefully Gifford will always be there with physicians and staff members who reflect the values of the professionals highlighted in this report. Many things will change moving forward, but unchanged will be our commitment to you and our communities.

A Conservative Approach to Health Care Reform

The following is an excerpt from our 2011 Annual Report.

health care reform

Information Systems Director Sean Patrick sits amid the old way of keeping patient records – paper files – and the new way to come – electronic medical records updated by providers via new laptops or even iPads.

As lawmakers embark on an ambitious schedule to create a health care exchange required under the federal Patient Protection and Affordable Care Act by 2014 and a Vermont single-payer system by 2017, Gifford is mindful of its role as a community care provider.

The laws seek to bend the health care cost curve, in part through information technology, advanced primary care and payment reform.

Through the implementation of Vermont Blueprint for Health initiatives, Gifford is embarking on reform initiatives including care coordination for the chronically ill and recognition of Gifford’s five primary care practices as Patient-Centered Medical Homes.

The medical center has chosen an electronic medical record (EMR) vendor and is progressing toward both the installation of an EMR system and meeting federal requirements for “meaningful use” of electronic health records (EHRs). EMRs are internal electronic medical records. EHRs can be viewed by appropriate outside entities, including specialists and providers from other hospitals.

Gifford’s modest budget requests and responsible spending also align with reform, notes Trustee Paul Kendall, who actively follows reform legislation.

But the non-profit community medical center is by choice not at the forefront of reform efforts.

Gifford Administrator Joe Woodin likens health care reform to a passing ship. Where others might be quick to jump on – appropriately, the region’s larger health care providers – Gifford is waiting to ensure the medical center commits to the best choice for
Gifford’s size, patients and rural area.

“Gifford is more inclined to stay on the dock and wait for the boat to come around on health care reform,” Joe says. “It takes a lot of fortitude to humbly wait for the boat to make a reiteration.”

“We continue to be watchful of what’s going on and gradually position ourselves to do
what is right and appropriate,” agrees Paul, noting some initiatives like information
technology upgrades can require huge investments of time and financial resources.

conservative approach to health care reformGifford also strives to be a voice in discussions leading up to reform legislation. Leadership is suggesting cost-saving ideas the state could pursue now. They continue to set a standard
for financial stability and maintaining strong relationships with other hospitals, state and federal lawmakers, and health care organizations, like Bi-State Primary Care and the Vermont Association (VAHHS).

VAHHS represents the state’s nonprofit hospitals before lawmakers and the Green Mountain Care Board, which was created by the Legislature in 2011 to oversee the creation of a single payer Vermont system. Bea Grause, VAHHS president and chief executive officer, sees small hospitals’ role in health care reform as one of preserving local access to high-quality care.

“Hospitals are seeking to create reform opportunities by working with the Green Mountain Care Board and federal lawmakers that will balance the need to contain costs with the need to ensure sufficient revenue that will help hospitals meet their local missions,” she says. “Issues such as recruitment and retention of physicians and other health professionals, improving quality, ensuring access and long-term financial sustainability are just a few of the challenges small hospitals will face as Vermont and the entire industry prepare for a decade of continued change on all levels.”

Gifford’s work with Bi-State Primary Care in part addresses the recruitment piece.

Bi-State Primary Care is a nonprofit membership organization of Vermont and New Hampshire rural health care providers working to support primary care practices in medically under-served areas. Its members represent more than 175,000 Vermonters. This equates to one in four residents, or 46 percent of Medicaid enrollees and 52 percent of the state’s uninsured.

The organization is working on Gifford and small, rural primary care practices’ behalf to improve access by recruiting providers to underserved areas. They are also working on health information exchanges and quality improvement initiatives.

The ultimate challenge the state – and likely hospitals by default – will face for successful health care reform, however, will be answering the question: “What can we afford?”

“There are a lot of uncomfortable issues with health care reform that we don’t talk about. The most common issue is ‘what can we afford,’” Joe says, hoping lawmakers will address that question. If they don’t, it will fall on hospitals, which will be given limited funds to provide care. They will have to make tough choices on what care they can afford to
provide.