Sunil “Sunny” Eappen, president and CEO of the University of Vermont Health Network, in South Burlington on Thursday, December 15, 2022. Photo by Glenn Russell/VTDiggerThe University of Vermont Health Network plans to make a series of service cuts at medical facilities across the state, eliminating or trimming services in multiple areas. The network announced plans to eliminate the transplant department at UVM Medical Center, shutter an inpatient psychiatric unit at Central Vermont Medical Center, offload dialysis programs in Newport, Rutland and St. Albans, and close two clinics in the Mad River Valley.  UVM Medical Center, in Burlington, is also slated to reduce its census of inpatients — currently about 450 — by about 50. Health network leaders blamed the reductions on recent orders from a key health care regulator that limit how much revenue the network’s hospitals can raise from medical services and how much it can charge commercial insurance for those services.“Today’s a hard day for our organization and for our leaders,” Sunny Eappen, the CEO of the UVM Health Network, said at a press briefing Thursday morning. “We’re having to take action on a number of measures that we don’t want to be doing. But as a result of the decisions by the Green Mountain Care Board, we’re being forced to do that.”The network’s changes could impact care across Vermont. UVM Medical Center now performs roughly a dozen kidney transplants a year. Once those stop, patients will likely go to Dartmouth instead, administrators said. The health network is also hoping to transfer dialysis centers in St. Albans, Newport and Rutland to other operators. Those centers currently serve about 115 patients and lose about a combined $3 million annually, the network said.UVM Health Network also plans to shutter a family medicine clinic and a rehabilitation clinic, both affiliated with Central Vermont Medical Center, in Waitsfield.“Those providers and staff will be moved to existing primary care locations,” said Anna Tempesta Noonan, Central Vermont Medical Center’s president and chief operating officer, “the closest being the Waterbury clinic that we have, which is approximately 12 miles from where our current practice is in the valley.”Central Vermont Medical Center’s inpatient psychiatric unit, which currently has eight patients, will also shut down. Noonan said that the hospital was working to provide lower-level psychiatric care elsewhere in the hospital, through “enhanced services” in the emergency department and “psychiatric supports” in primary care facilities. In Burlington, UVM Medical Center is seeking to decrease the number of patients that stay overnight from the usual 450 to about 400, by limiting transfers to the hospital and removing barriers to getting patients into lower-level facilities like nursing homes. It was not immediately clear how the hospital would do that. Network administrators said that the cuts will affect about 200 employees in total. The hospitals plan to not renew contracts for roughly 100 traveling staffers and find other positions within the network for another 100 permanent staff.UVM administrators provided no timeline for the cuts, saying they will likely take months to implement. Regulators respondThe Green Mountain Care Board regulates how much hospitals can raise in revenue from caring for patients and how much those hospitals can charge commercial insurers for providing that care. Earlier this year, UVM Health Network hospitals asked the board for permission to increase their patient revenue by an average of about 8.5% per hospital. The board, however, allowed UVM Health Network hospitals to increase that revenue by an average of 4.6% per hospital. And the board limited how much the network’s hospitals could increase their private insurance rates as well. In fact, board members ordered UVM Medical Center to decrease its charges to commercial insurance by one percent. UVM Health Network administrators have expressed frustration and disappointment at those orders and are currently appealing them. But administrators say they are moving forward with cuts in the meantime.Owen Foster, the chair of the Green Mountain Care Board, said in a statement Thursday that the board had learned about the network’s plans Wednesday and had not approved the cuts. The board “is deeply concerned about the impact of UVMMC’s decisions on patients, its dedicated staff, and the broader healthcare system,” Foster said. The board’s orders, Foster noted, had allowed UVM Medical Center to increase its budget by $64 million over the previous year. “As set forth in its budget order, the (board) found that compared to other hospitals UVMMC has significant opportunity to improve its expense management and control the excessively high prices it charges commercially insured Vermonters,” Foster said. He said that the board was seeking to better understand how administrators came to their decisions.Read the story on VTDigger here: UVM Health Network announces widespread service cuts.