Is the Approval of Additional Investment in Population Health Important?

Yes!  The Green Mountain Care Board’s (GMCB’s) reconsideration of NMC’s proposed Fiscal Year 2016 budget to allow NMC to invest approximately $1.1 million in prevention efforts is a significant step forward in our efforts toward improved population health and our community’s efforts to embrace healthier lifestyles!  Members of the GMCB called NMC’s proposal “innovative” and “inspiring” and they showed their support for our commitment to wellness with a 5-0 vote of approval.

NMC’s Fiscal Year 2016 budget proposal to the GMCB included a request to reduce our rates 8%, even with our rates typically below State average and no other Vermont hospital having a lower cumulative rate increase over the past 13 years.  Their initial ruling on NMC’s budget was to adjust that rate decrease to 10%, a difference of more than $1 million.  With insurance company rate increases already approved, we felt that an additional rate reduction would not have a direct impact on most individuals and businesses in the communities we serve.  Therefore, we had asked the GMCB to reconsider and shift their focus from cutting revenue to increasing our investment in improving population health (which means helping you and every individual in Franklin and Grand Isle counties to live a healthier life).  

We recommended using that $1 million for integrated strategies to advance our healthcare reform efforts.  We will increase investment in community care management to provide RN Care Management and Mental Health Wellness Counseling resources, working with vulnerable populations and improving how we work with other health care agencies to ensure the best transitions of care as your care needs change.  These efforts will span the continuum of care, coordinating with resources in the Emergency Department and Inpatient Units and reaching out to resources in the community, including RiseVT.  By wrapping around patients in need and helping them access crucial community support, we can reduce lengths of stay, readmissions, preventable hospitalizations, and avoidable ED visits.  That saves money within the healthcare system by avoiding those more costly follow-ups.  To increase our impact, we will establish a “flexible funding” option to be used by our care managers to remove barriers to health and creatively incent better choices in target populations, further increasing the chances of preventing  avoidable costs. 

We proposed building upon the success of the RiseVT initiative and NMC Lifestyle Medicine’s other prevention efforts.  We will embed a full time health coach within a local school (selected based on need and readiness) to pilot efforts to improve the health of the students, their families, and the staff.  This will help leverage improvements in school policy and culture to enhance the use of existing resources, boost walking and biking to school, and improve healthy eating.  We will be making additional investments in tobacco prevention and cessation, to continue the momentum that has lowered our community’s adult smoking rate from 24% to 17% as we pursue the State’s 2020 goal of reducing it to 12%.  Additional investment will also be made in the promising “Healthy Roots” initiative to increase access to fresh, local, healthy foods.  We will be expanding “gleaning” in our community to intercept unsold food on local farms before it goes to waste and create systems to enable existing food distribution sites to get this food to local people in need.  We are targeting saving and repurposing more than 1500 pounds of healthy food in the first year!  We proposed expanding the pilot of NMC’s Lifestyle Medicine Clinic to include at-risk individuals through care management of patients covered by Medicaid from within our Primary Care practices and also from among entry-level workforce members at local businesses.  The clinic is a complement to the Vermont Blueprint for Health and primary care that assists individuals in identifying and adopting healthier behaviors that lead to targeted health improvements. 

With a focus on the future, we will engage in formal evaluation of our efforts, leadership development to enable us to keep pace with best practices, and work with the GMCB to explore bringing the RiseVT approach statewide, possibly in alignment with the internationally-proven EPODE model (a targeted approach to reducing childhood obesity that has consistently demonstrated remarkable results). 

We could not have accomplished results in this community in such little time to share with the GMCB without the vision and engagement of the Community Committee on Healthy Lifestyles that formed over two years ago.  I could not be more proud to co-chair this committee with Judy Ashley, District Director of the Department of Health, surrounded by passionate members to improve everyone’s health through RiseVT.  It was so exciting to have members of the operations team speaking passionately to the GMCB about their initiatives and commitment to RiseVT.


We firmly believe that improved population health is the key to true healthcare reform in Vermont and that preventing the need for care is the best strategy to reducing the overall cost of healthcare.  Having the GMCB endorse our vision is a wonderful step forward.  We have healthy momentum in our community, a growing number of remarkable community partners, a deeply committed team at NMC.  Together, we can shape a healthier future.  Please join us!  Visit www.RiseVT.com for more information on embracing a healthier lifestyle! We really have something special going on in Franklin and Grand Isel counties.  We have a great challenge ahead to influence measureable outcomes that indicate our counties are living a healthier lifestyle.  We need your help on this one to prove we can do it!

— Jill Berry Bowen, NMC’s Chief Executive Officer