Fletcher Allen CEO Says Health Care Cost Is Biggest Challenge

08/03/11 5:50PM By Jane Lindholm
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AP/Toby Talbot
Fletcher Allen Health Care in Burlington is Vermont's largest hospital.

(Host) Fletcher Allen Health Care CEO Melinda Estes will be stepping down this month, to take a similar job at a much bigger hospital system in Missouri. 

She's been reflecting on her time at Fletcher Allen. And, as VPR's Jane Lindholm reports, sharing her thoughts on some of the larger issues facing the health care industry.

(Lindholm) Dr. Estes has been at the helm of the state's largest hospital network during a time of stress and transition for the health care industry.  In her eight years as CEO, Fletcher Allen has completed a controversial expansion project, announced strategic alliances with other hospitals throughout the region, and recently implemented an electronic medical records system. 

Now, the big challenge in Vermont and around the country, Estes says, is figuring out how to pay for health care without diminishing service.

(Estes) "I personally am less concerned about whether it's a single-payer health care system, a multi-payer health care system, or a fewer-payer healthcare system as long as providers are paid in a sustainable and fair fashion."

(Lindholm) Estes says it's a bold move for Vermont to attempt to lead the nation on health care. But she's concerned about just how many details there still are to be worked out.

(Estes) "Details that the Green Mountain Care Board is going to have to work through.  I don't envy them their task.  One of the things that all of us are very interested in is seeing who is on that board because they have a Herculean task and health care is very complex.  We're hopeful that in the provider community we can also be a resource and part of the solution as Vermont moves forward."

(Lindholm) Dr. John Brumsted is Fletcher Allen's Chief Medical Officer. And he's been appointed interim CEO while a national search for Estes' replacement is under way. 

Estes says she leaves the organization in great shape, with improved staff morale and more fiscal stability.  But she says whoever takes over will have a lot to contend with to keep Fletcher Allen on the right path.

(Estes) "We have a wonderful outpatient facility but our inpatient facilities we do need to upgrade and we have a master facility planning process underway.  They need to embrace that; move that forward...The sustainable financing for Medicaid, particularly in the state of Vermont, is an issue my successor will have to address.  Currently we are paid 34 cents for every 1 dollar of costs and that is simply not sustainable. The state has been willing to talk with us and listen, but it remains an issue."

(Lindholm) Estes leaves her post at Fletcher Allen Health Care later this month and will become the new president and CEO of St. Luke's Health System in Kansas City.

For VPR News, I'm Jane Lindholm.

(Host) And we should mention Dr. Melinda Estes is a member of the VPR Board of Directors.

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