This commentary is from Rob Hoffman of Quechee.
The Green Mountain Care Board of Directors is currently deliberating on submitting the 2022 annual budget for Vermont’s responsible care organization model, OneCare Vermont, whose parent company is the University of Vermont Health Network.
OneCare has been named as an all-pay model partner with existential importance. For Vermont to cap cost growth without limiting access and quality of care, reducing health care costs must be achieved through the purported economic benefits of coordinated care.
This requires investments in the case of OneCare in so-called “population health management” (PHM in the graph) investments. As a nonprofit, this would be considered the mission part of OneCare’s stated nonprofit goal.
Since 2020, based on the request for OneCare from the Green Mountain Care Board, these critical investments in population health management have declined by $ 3.8 million, or 11.6%, while the total salaries and benefits increased $ 1.3 million, or 15.6%, and total administrative costs increased by $ 1.24. million, or 8.9%.
In this context of decreasing mission expenses in favor of an increase in personnel expenses for less work, it is important to consider the compensation of the management of OneCare. Leaders of responsible care organizations are normally paid as members of the hospital leadership team, which is the case for each of OneCare employees; their checks are drawn on the accounts at the University of Vermont Medical Center.
This distinction is important. This highlights that a business unit – in this case, OneCare – within a hospital, while having titles like CEO, is still only a vice president of the parent organization.
During Green Mountain Care’s annual board budget process, OneCare was asked to provide an evidence base for its compensation levels against industry benchmarks. He did not do it in a substantial way.
The table below shows OneCare’s total executive compensation, the national median hospital director compensation, and the variation between the two.
As can be seen in the variance column above, OneCare’s leadership orders an additional $ 1.3 million, which is double the national median compensation for the same roles.
Important points to remember:
- Total compensation for OneCare staff increased by $ 1.3 million.
- OneCare’s total operating budget has increased by $ 1.24 million.
- Therefore, all requested budget increases are related to personnel to perform fewer missions amounting to $ 3.8 million.
- Meanwhile, OneCare executives are paid twice as much – or $ 1.3 million more than – the national median compensation for the same roles
Vermonters should ask the Green Mountain Care Board and their local lawmakers to require the following:
- Green Mountain Care board to level funding for OneCare’s population health management / mission investments through 2020.
- Green Mountain Care’s board is to proportionally reduce the organization’s total compensation – funded by level through 2020.
- Green Mountain Care board to reduce total executive compensation to national median levels.
At a time when Vermonters die and commit suicide in pain, waiting months and even years for treatment, it is inconceivable that meager taxpayer and taxpayer incomes will be redistributed upward to elites.
Green Mountain Care’s board of directors is currently accepting public comment on the proposed OneCare budget.
I encourage Vermonters to copy and paste the above three requests and submit them as “ACO Public Comments” to Christina McLaughlin at [email protected] and write and call on their legislators, demanding greater fiscal prudence with their meager taxes and premiums.