The possible loss of small Vermont hospitals could be a problem for the state, said Claudio Fort, president and CEO of Rutland Regional Medical Center.

Fort was invited to the Herald offices Thursday to reflect on his first year at the Rutland hospital.

Asked about whether the problems at small hospitals like Springfield Hospital would be an opportunity to expand or a stressor forcing a hospital to expand its services, Fort said it was more likely to cause tension in systems that are already stretched thin.

Fort said while administrators at RRMC were sensitive to the situation in Springfield, Gov. Phil Scott has already considered that possibility.

“That’s why he appointed my predecessor, Tom Huebner, to kind of represent the governor’s office in the Springfield situation, and has asked the local hospitals to convene to say, ‘OK, what can we do to support the situation and what is the contingency if Springfield did close or close a service? Can the other hospitals pick up the slack,’” he said.

Efforts are being made to save Springfield’s medical center. Fort said it would be stressful if the hospital were to fail.

Primarily, he said, it could be difficult for residents of the Springfield area who might now be 40 minutes from the closest emergency department.

“I think it’s a real challenge in Vermont because of the geographic challenge we have and the winter weather. We’re not driving on perfectly flat highways to get to the next hospital, we’re going over mountains and mountainous terrain. It is a big challenge for people who are sick and elderly, which is a large part of our population, to get there to get access,” he said.

The future survival of small hospitals in Vermont is something that administrators are already considering, Fort said, and it’s also a concern of the Green Mountain Care Board.

RRMC is already seeing more utilization of its emergency department than its staff and facilities can easily support, but Fort said the challenges could extend beyond the loss of medical services.

“There’s also the other things that a hospital brings to a community. The social and certainly economic impact hospitals have on your community,” he said.

Fort compared the potential impact to that felt by Vermont towns that could lose their local school to consolidation.

“No community wants to lose, especially no small rural community, wants to lose their school, which is kind of a hub of activity for them. Likewise, they don’t want to lose their hospital,” he said.

However, Fort said it wasn’t clear whether small, rural hospitals can survive no matter how much they’re valued by their community.

“It’s a great question. Can the independent hospital still survive? We’re seeing less and less of them throughout the country,” he said.

Leaders of hospitals considering consolidation should try to be as clear as they can about what they hope to gain, Fort suggested. But there are challenges to trying to remain small and independent, he added.

Fort said there was a hidden cost for communities that lose their hospital. Hospitals are providing health services for which they receive no direct compensation based on the theory that healthier communities are less expensive to treat.

“I look at all the things that Rutland Regional does, kind of outside its scope, that really have a downstream effect on the health of its community. I don’t think you see that on a balance sheet what that impact is, but I think you would see actual health costs go up because if a hospital’s not there, not providing that hub, people aren’t going to get access to care, and that delayed access is going to be a liability,” he said.

patrick.mcardle

@rutlandherald.com

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