Vail Health/Provided Photo
Vail Health System continues to grow and evolve amid industry-wide headwinds and impending regulatory changes, Vail Health CEO Will Cook said Tuesday at the Vail Health Governor’s Office. said in a speech.
At this annual event, Mr. Cook provided an overview of the organization’s recent achievements and challenges, as well as its future goals and priorities.
Advance
Vail Health’s 2023 accomplishments include not only progress and expansion, but also superior financial recognition and awards.
We opened a new facility in Summit County, started a home-based palliative care program at Shaw Cancer Center, and built 87 workforce housing units in Fox Hollow, Edwards. When completed this year, Fox Hollow will nearly double Vail Health’s workforce housing inventory.
Vail Health saw the most growth in 2023 due to its continued focus on behavioral health.
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“We’re very focused on how to solve a once-in-a-lifetime crisis, and it wasn’t COVID, it was actually mental health and substance use disorders,” Cook said. “We’re on the road. We’re not out of it yet and probably never will be. This is a disease similar to cancer, but we’re very grateful for the progress we’ve made here.” doing.”
Following a $60 million commitment to behavioral health from the Vail Health Board of Directors in 2019, the Vail Health Foundation launched a fundraising effort to raise $100 million for the same purpose. On Tuesday, Cook reported that the foundation had raised $88 million toward this goal. A quarter of that amount, about $28 million, went to nonprofit organizations outside of the Vail Health community, he added.
Vail Health Behavioral Health also continues to grow its infrastructure. This includes the February 2023 opening of Weeger’s Mental Health Clinic, Edwards’ outpatient behavioral health clinic, while Precourt Healing Center, a 28-bed inpatient facility scheduled to open in 2025. Construction continues next door. The Vail Health Behavioral Health Innovation Center researches new mental health treatments.
Vail Health is also expanding its behavioral health services to Summit County, becoming the county’s officially designated community mental health center in July 2023. Chris Lindley, Vail Health’s Chief Population Officer and Executive Director of Vail Health Behavioral Health, is responsible for Summit County, Project Building Hope, Summit Community Care Clinic, and Summit County Sheriff’s Department. He said that he is working on building a “shared model.”
face challenges
As the organization moves forward and evolves, Cook said, “The most important thing is that we are an independent regional health system.”
“We are a nonprofit organization. We do not send margin or resources back to the Front Range system. We do not send it back to the national system. We do not send it to our shareholders. We’re here to serve. That’s our mission. I think that’s what makes us different,” Cook added.
However, he noted that while this independence is important, it also brings challenges.
economic headwinds
“I don’t think there’s any industry in the world that hasn’t felt the pain post-pandemic, and certainly healthcare,” Cook said, citing an aging population and shrinking workforce, hyperinflation and volatile markets. That’s one of them.” We are in a very, very difficult financial situation. ”
“We saw our financial performance fall off the same cliff as other companies,” Cook said.
“As a result of downward pressure on reimbursement and upward pressure on costs (largely due to regulatory burdens), mass retirements and reliance on a very expensive temporary workforce, the health care industry, and Colorado in particular, is in real trouble. “I was forced to stand up,” Cook said. He said.
Cook reported that in Colorado, 70% of hospitals currently have unsustainable operating margins, most of which are independent hospitals in rural areas.
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Cook said independent health systems in small communities “often don’t have the revenue to cover the infrastructure they need to remain independent,” including IT, revenue cycles, cybersecurity and human resources. etc.
“All of this requires infrastructure that costs money. And when your company isn’t very large and you have limited revenue even after these expenses, it’s hard to make the numbers work. ” he said.
The presentation noted that expenses have increased significantly across the board and are still on the rise. This includes expenses that have exceeded revenue by more than 10% even before the pandemic, payroll costs that have increased by 6% in 2023 (still short of the 15% increase in 2022), and increased and increased 30% since 2019. Includes trending supply costs. In 2023.
However, Cook reported that although he made some tough decisions last year, “we are on the right path.”
“Since the first quarter, operating margins have actually returned to positive territory,” Cook said, adding that financial performance has not yet returned to pre-pandemic numbers.
“We’re by no means out of the woods,” Cook said.
Cook said continuing to address these financial challenges “will include making some difficult decisions this year.”
regulatory changes
Cook said changes in laws and policies also threaten Vail Health’s independence.
“In health care, especially in Colorado, there’s a lot of legislation that’s aimed at lowering health care costs, increasing transparency, and making some pretty fundamental changes, some of which we’ve gotten.” Mr Cook said. “I’m certainly not saying there haven’t been opportunities to improve health care, but some of them have unintended consequences that actually put more pressure on independent hospitals.”
Two big pieces of legislation that Vail Health focuses on are facility neutrality and facility fees. Specifically, Vail Health expressed concerns about the reimbursement implications of facility neutrality and facility fee bans, which could threaten the long-term viability of certain service offerings. He said there is.
“It doesn’t really help medicine in the long run,” he says. “It’s actually hurting.”
As part of our advocacy efforts, Vail Health recently participated in an economic impact study with several other independent hospitals and health care providers on the Western Slope. Vail Health, conducted in partnership with the Western Healthcare Alliance and the University of Colorado Boulder’s Leeds School of Business, found that “significant economic contributions are made by many health systems in these communities. I wanted to show that there is. Including ours. ”
Rural challenges
Mr Cook said that as a “rural independent health system” some things were “very difficult for us”.
Cook said part of the reason is Vail Health’s “geographical distance from other resources.”
“We need to have a higher level of clinical infrastructure in place because that’s not critical. If something happens in the emergency department and we can’t transfer, we have a responsibility to take care of that patient. And that’s putting a huge strain on our health care providers and staff,” Cook said.
This can also impact employee recruitment and retention, particularly in professional services.
“It’s very difficult to hire just one surgeon. Make sure they have adequate backup to ensure they can take planned and unplanned time off to ensure they continue to develop their skillset.” said Mr. Cook. “It’s not easy to have all the medical and surgical specialties in this valley because we don’t have enough of the population to have the capacity, to ensure the quality, to ensure the cost efficiency.”
“If you don’t have enough volume, if you don’t have a high enough incidence of something, and you only have one person in charge, you’re preparing in case that person leaves,” he added. “Be prepared in case something happens to that person. It’s not fair to that one doctor from a burnout standpoint.”
Vail Health is currently grappling with this issue as it recently announced that Dr. Julie Barone, a breast oncoplastic surgeon and medical director of the Breast Care Center at Shaw Cancer Center, will be leaving the Valley. Barone has accepted a position as medical director of the breast program at Mission Hope Cancer Center in California. Cook said in Tuesday’s presentation that she received many questions regarding her departure, which will be formally announced on May 2.
Currently, Vail Health is “moving forward with interim and long-term plans,” he said, adding that it will continue to offer breast surgery in the Valley as part of Vail Health and Shaw Cancer Center.
Mr Cook noted that collaboration and partnerships with other local independent organizations will be important as we look to long-term planning.
“Just as we have done with behavioral health, we are talking to anyone who needs to be talked to to find ways to leverage and share valuable resources,” Cook said. Ta.
“When we talk about the mountain communities we serve, it’s not just the Eagle River Valley, it’s Summit County, it’s the Roaring Fork Valley. We are very focused on how we can ensure that we can protect the local nature by working with other providers in their respective markets.”
Looking to the future
In addition to strengthening cooperation and partnerships between Eagle County and other communities, Cook also briefed attendees on the organization’s future prospects.
In 2024, this includes continued advances in behavioral health, the completion of construction of the Precourt Healing Center and Fox Hollow Apartments, and the first research on psilocybin as a treatment for depression as part of the Center for Behavioral Health Innovation. This includes the initiation of research into
“Our vision is to one day provide behavioral health services on the Western Slope. To have a model that can stand on its own, to have a model that looks at new treatments, to have a model that looks at what we’ve seen over the last 20, 30 years. “It’s about having a model that delivers different results than what we’ve been used to,” Cook said.
Other growth areas include a continued focus on the social determinants of health and care (and blue zones) for the whole person, and the expansion of health services for older adults.
“As the demographics are changing and that means the population here is getting older, we need to figure out what services Vail Health can and should provide. It’s well within their capabilities,” Cook said. . “That’s one area where we think there is opportunity.”
