ADVOCACY SPOTLIGHT
Trail Blazing Vermont gets its first multi-specialty ASC BY SAHELY MUKERJI
In July, state regulators of Vermont approved a cer- tificate of need (CON) for the first multi-specialty and second independent ASC in
the state. Amy Cooper, executive direc- tor of HealthFirst in Burlington, Ver- mont, talked to ASC Focus about her experience with the process that took three years to come to fruition.
Q: What obstacles did you have to overcome during the CON process and how did you overcome them? COOPER: Regulators and state officials had very lim- ited knowledge of the ben- efits of ASCs and the role they play in the health sys-
tem. We used material from ASCA, industry journals, the Medicare Payment Advisory Commission (MedPAC) and peer reviewed studies that documented the benefits of lower costs, greater effi- ciency and equal or better quality to hos- pital outpatient departments (HOPD). We faced strong resistance from
the Vermont Hospital Association. We educated patients, consumers, busi- nesses, employers and, importantly, the local media, on the benefits of ASCs. They in turn stood up and added their voices to the chorus in support of our project. I think this was crucial in combatting some of the unsubstanti- ated negative arguments coming from the hospital association.
The whole process took about three
years. We submitted the application to the Green Mountain Care Board on July 2, 2015, and its decision came on July 10, 2017. We had been planning the project for about a year prior to the application, so it has been three years from my perspective.
In those three years, we had many meetings with employer and con-
We faced strong resistance from the Vermont Hospital Association. We edu cated patients, consumers, businesses, employers, and importantly, the local media, on the benefits of ASCs. They in turn stood up and added their voices to the chorus in support of our project.”
—Amy Cooper, HealthFirst
sumer groups to educate them about the benefits of ASCs. We received at least 25–30 letters of support from these groups that we submitted to the board. The meetings were easy once they understood what an ASC was and that it was the way to operate more effi- ciently and offer the same services for better prices. So, it was not a hard sale. In Vermont, we do not have ASCs, so that was a bit of a challenge because people we were talking with were not familiar with ASCs. However, we had people in the groups we met with who
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26 ASC FOCUS OCTOBER 2017 |
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had travelled to other states for care at ASCs, so that made it somewhat easier.
Q: What did you see as the most important action that you took to secure your CON? COOPER: Getting patients, employ- ers and the press educated and involved. Also, preparing an applica- tion that spoke directly to the need for more affordable health services, more options, reduced wait times and a smaller patient-friendly environment. There were some folks in the com-
munity, in particular, legislators, who came in with a negative view of ASCs because for the last 30 years, hospitals have been saying that ASCs were not good. We needed to overcome that. We certainly did not win over everyone, but we benefitted from a lot of new faces who had come in as legislators and regulators. They were able to see our message for what it was despite what the state’s hospitals had been say- ing for the last 30 years. They outnum- bered the older folks, ultimately. Our team has physician investors,
lawyers and consultants; altogether, 15 folks. There are 14 hospitals in Ver- mont, and they have their own lob- byists and an association. The Ver- mont Hospital Association was within the top three organizations spending money in Montpelier, our state capi- tal. The University of Vermont Medical Center spent on par with the hospital association on lobbying in Montpe- lier. We were up against stiff compe- tition. However, we went directly to the patients, small businesses, employ- ers and consumers who were directly affected and went around the lobbyists. We had a consumer committee that met. We actively engaged consumers and had them write in public comments on the regulatory comment board that
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