Becker's Hospital Review

9 CFO / FINANCE Why UVM Health won't cut clinical services in 2026 By Kelly Gooch S teve Leffler, MD, began serving as interim CEO of Burlington-based University of Vermont Health in October, when Sunny Eappen, MD, stepped down. Coming into the role, Dr. Leffler recognized the need for financial trade-offs. "In our rural region, as across the country, people are struggling with the cost of healthcare," Dr. Leffler told Becker's. "UVM Health has committed to evolving as a health system to better meet the growing needs of our patients, while operating more cost effectively. We need to cut expenses, but improve quality and access at the same time." With that in mind, UVM Health, a rural academic health system with about 15,000 employees, has committed in 2026 not to cut any clinical services, despite significant financial pressures. "To do that, everything's a balance. If you're going to have your expenses come down, without cutting clinical services, there has to be give on the support structures or the other functions that support that," said Dr. Leffler, who is also president and COO of the health system's University of Vermont Medical Center. As part of this balance, the health system will spend less capital in 2026, though the organization has huge demands for capital, Dr. Leffler said. UVM Health includes UVM Medical Center in Burlington, Central Vermont Medical Center in Berlin, and Porter Medical Center in Middlebury, Vt., as well as multiple hospitals in New York and a home health and hospice care provider. UVM Health has also made administrative cuts as part of an organizational restructuring, including eliminating some leadership roles. By the end of 2025, the health system will phase out its COO, chief medical officer and chief of staff positions. Mark Gordon, Danielle Mahaffey, MD, and Brittany Sheehy serve in those roles, respectively. Jason Williams, health system chief external relations officer, is also resigning as part of the transition. The objective of the transition is to create "a more efficient system of leadership and governance structure that is more closely connected to the communities we serve and better aligned with the system's anchor academic medical center," the health system said in a previous statement shared with Becker's. The C-suite layoffs follow the elimination of 146 vacant and full-time roles at the health system in July and a pause in performance-based pay for leaders for fiscal 2025. Dr. Leffler said UVM Health is also continuing to look at non- patient-facing expenses "to see where we can continue to be more efficient and effective." Additionally, he said the system is improving efficiency in terms of care delivery by reducing duplication, streamlining workflows and investing in technology — including AI — that helps clinicians spend more time with patients and less time on paperwork. "We've committed to being transparent with our teams, our state and federal partners, and our communities, and are sharing information and the reasoning behind our decision-making as early and often as we can," Dr. Leffler said. "Figuring out this balance of improving quality and access while reducing expenses is a tall order, but I believe our health system is up to the challenge, because we have to be." n Health Network] and UPMC. One of the things we've done with our insurance arm is we've really structured Peak to be a cost center. We try to closely align the financial incentives of our insurance provider with the hospitals and care delivery arms of our health system and I think that is something that is unique. It's small and it's sort of in its infancy, but it's something we've found to be very successful in executing our mission of improving the lives and the trajectory of patients that we serve. … We're really proud of what we've accomplished and we think together with Independence we can supercharge that initiative. Q: What are the key milestones in your integration timeline for clinical, IT and workforce alignment? AW: is is a big deal. We'll take the next six months or so to try to gain some state of Pennsylvania and some federal regulation and legal approvals. Once we get those, we can execute our definitive agreement and just go through some of the dotting of the eyes and crossing of the T's to have the Independence Health System become a full member of the WVU Health System. We hope to close on that by right around, on or around Oct. 1, 2026. en your real integration of your operating systems, like Epic and some of the shovels in the ground for some of these projects that will both work day in as our ERP, and we'll move employees on to our Peak Health provider sponsored health plan that we've been growing over the last few years. So that will all happen aer that closing date of [Oct. 1, 2026]. For some of the clinical integration … I think … those things will happen organically. One of the things we're blessed with here at WVU medicine is over the last 10 years, we've moved from being an academic medical center to an academic health system when something like this happens right away. Our heart and vascular doctors, our neuroscience doctors, our critical care doctors, our cancer doctors, our pediatric doctors are already thinking, "Okay, we got a new member of the family. What do we have to do?" Support and make sure we're integrated with our cancer services and our spine program. ey make my job a lot easier for me thinking that way. Q: Are there any plans for future growth at WVU Health System? AW: We've drawn a radius around our service area … it encompasses the entire state of West Virginia, Virginia, Maryland, Pennsylvania and Ohio. We still believe in regional and adjacent healthcare. You are seeing some nonadjacent healthcare mergers. I'm not sure we're there yet. Our thoughts might evolve. Right now, it's being a major regional player in those areas, but we'll look at opportunities. is is a big one for us. We want to make sure that we've got a good integration plan so we can live up to our promises, but we're always open to look at opportunities and see if they can help us meet our mission and then we can be successful. n

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