The Southwestern Vermont Health Center's Board of Trustees approved an affiliation between SVHC and Dartmouth-Hitchcock Health, according to SVHC Communications Director Kevin Robinson. The affiliation will allow SVHC and DHMC which falls under the Dartmouth-Hitchcock Health system to exchange ideas, conduct collaborative research projects and share physicians' services and professional opinions between the two medical centers while the hospitals adjust to national health care reform, Robinson said.
The partnership will enable SVHC to explore other payment methods and change the way patients pay for medical services, according to according to Mark Donavan, chief medical officer of SVHC. Although DHMC and SVHC are both currently on a "fee for service" system that requires patients to pay for each unit of treatment they receive, DHMC recently received a grant to study various ways to minimize unnecessary procedures and medical fees, according to Robinson. DHMC will share its findings with SVHC, which will help the hospital upgrade to a new payment model in which patients pay for "certain quality and utilization factors," according to Donavan.
Although health care reform is still under debate in Washington, medical professionals at DHMC and SVHC expect that reform will require collaboration among medical centers to assess cost and procedure "utilization," according to Robinson.
"[By partnering with SVHC], DHMC will be able to work more closely with the models in a rural setting," Robinson said. "Reform is still so vague, but Dartmouth-Hitchcock is in a position to help shape debate nationally."
Hospitals in some areas of the country perform a significantly greater number of medical procedures but do not see marked improvement in patient health, Donavan said. DHMC and SVHC will work together to develop a cost-utilization model, however, which involves assessing which procedures to perform on patients based on their cost and effect on health, according to Donavan.
"We expect an accountable care organization will be formed that will require community hospitals, specialists and tertiary care hospitals to work together to reduce high-cost utilization of hospitals and move health care out into primary care because that's a lower cost," Robinson said.
Although the details of the affiliation have not been fully decided, both hospitals expect to benefit from the partnership, Robinson said.
Robinson said SVHC's association with a nationally-renowned hospital like DHMC will help SVHC recruit talented physicians.
"In a rural health system it's becoming more and more difficult to recruit physicians," Robinson said. "They like to practice in an environment that has a certain academic quality to it and the affiliation will allow them to work with colleagues from Dartmouth-Hitchcock."
SVHC administrators hope to learn from DHMC's management of a large network of physicians and get advice on how to improve clinical quality, according to Robinson. While SVHC employs 65 physicians, DHMC has approximately 900 physicians on its payroll, Robinson said.
The partnership, however, is not a merger and each hospital will remain a separate entity, according to Robinson. The affiliation is a "major" part of a greater strategic planning exercise that SVHC began last spring as a "look into the future as health care changes," according to Donavan.
"At this point, we don't know whether there is a financial component but integration will be mostly around clinical ventures," Robinson said.
SVHC is financially stable despite its size and rural location, Donavan said.
"We're not seeking a bailout," he said. "Some small hospitals are in a significant financial situation but we aren't. This is not a merger of financial assets it's more of a collaboration."
SVHC considered several other hospitals in their search for a partner, including Albany Medical Center and Fletcher Allen Health Care, Robinson said. DHMC has a history of affiliations with several nearby hospitals, including the Cheshire Medical Center in Keene, N.H. DHMC's positive relationship with these hospitals played a large role in SVHC's decision to establish an affiliation, according to Robinson.
"We met with the physicians and administration of the Keene clinic and were very impressed with their working relationship with Dartmouth-Hitchcock," Robinson said. "That was one of the things that influenced us to choose Dartmouth-Hitchcock."
The new partnership will encourage a regional connection between medical clinics in a time when the future of health care and hospital administration remains largely undefined, DHMC President Thomas Colacchio said in a Friday press release.
"Discussions such as these are consistent with Dartmouth-Hitchcock's vision of achieving the healthiest population possible and leading the transformation of health care in our region," Colacchio said. "We see this relationship with SVHC as a logical extension of our stated mission of advancing health through research, education, clinical practice and community partnerships."
SVHC is a community-owned, not-for-profit health system located in Bennington, Vt. SVHC serves patients in southwest Vermont, New York and Massachusetts. The SVHC consortium includes Southwestern Vermont Medical Center, the Centers for Living and Rehabilitation, Southwestern Vermont Regional Cancer Center, the Visiting Nurse Association and Hospice, the SVHC Northshire and Deerfield Valley Campuses and other medical practices, according to SVHC's website.
DHMC media relations manager Rick Adams declined to comment for this article.
