Via e-mail to
[email protected] February 3, 2011 William Hsiao, Ph.D. 124 Mt. Auburn Street, Suite 410 South Cambridge, MA 02138 Dear Dr. Hsiao: On behalf of Fletcher Allen Health Care, Vermont’s academic medical center, I would like to thank you and your team for the efforts you put into developing the draft Act 128 report issued on January 19. Despite the limitations placed on that work that you have described – a small budget and short timeframe – the draft report reflects a great deal of research, analysis and thoughtfulness. We also appreciate the many meetings you and your team hosted for so many stakeholders, including Fletcher Allen’s clinical and administrative leaders. We were pleased to see that many of the concepts that are common to the three major designs included in the report are ones that have been under discussion, or have been implemented in some form in Vermont, in the past several years. We at Fletcher Allen have been fully supportive of those reforms, and have already incorporated many of them into our operations and organizational culture. Those include: An integrated care system that includes ten primary care practices, a large multi- specialty physician practice (the University of Vermont Medical Group, physicians jointly employed by Fletcher Allen and the UVM College of Medicine), and a full spectrum of inpatient and outpatient care services. As recognized on pages 49 – 50 of the report, Fletcher Allen’s hospital service area is among the highest-performing in the three-state region discussed in the Tri- State Report commissioned by the Department of Banking, Insurance, Securities and Health Care Administration in 2010, including having the lowest per- member per-month costs; the lowest rates of Emergency Department visits, potentially-avoidable ED visits, and hospitalizations for ambulatory-sensitive conditions; and among the lowest hospital re-admission rates.