The Vermont Agency of Human Services announced Wednesday that it was launching an investigation into the problem of long wait times for medical appointments across the state. The news came just hours after Seven Days published a story detailing how Vermonters are waiting months for speciality care at the state's largest hospital, the University of Vermont Medical Center in Burlington.
Human Services Secretary Mike Smith told Seven Days on Wednesday that his agency had been hearing troubling reports of medical appointment delays "for a while" now.
"I thought it was time that we needed to look into this — and needed to look into it in a very substantial way," he said.
The Seven Days story documented the long-standing problem of wait times at the UVM Medical Center, which has reached a new crisis point. More than two dozen people told the paper that they had struggled to get timely appointments in recent years despite suffering from painful and debilitating ailments, such as kidney stones and chronic migraines.
One patient went more than two months without getting an appointment for what turned out to be metastatic prostrate cancer. Several staff members, meanwhile, said they are burning out under immense workloads and the weight of not being able to provide the highest level of care.
The state's probe — which will be led by Ena Backus, Vermont's director of health care reform — will not focus on any hospital in particular, nor will it be confined to just specialty care, Smith said.
"Obviously, UVM being the biggest network within the state, it will garner a lot of attention," he said. "But I don't want to confine it to just one institution. I want to look around."
Smith said there are numerous reasons for the state to improve wait times. For one, Medicaid makes it one of the largest health insurance providers. The public program, which is largely for low-income people, provides health insurance to roughly one in every five Vermonters, according to a 2018 report from the state Department of Health.
"One of the criteria of Medicaid is making sure that the network [of providers] performs up to standard," Smith said, "and that everybody involved in the program has the same access to care that everybody else has."
But while the state could seek to withhold Medicaid payments to hospitals that don't provide "the care that is expected of them," the goal of the investigation is not to punish anyone, Smith said. "I’m looking at how we can find out what’s going wrong, and how can we fix it." He said he hoped the probe would be concluded as soon as possible. "This is on the fast track for us."
UVM Health Network leaders admit that the medical center has a significant access problem but say it has largely been driven by external factors. They point to national workforce shortages that worsened during the pandemic, and note that patients who canceled appointments during the last 18 months are now showing up sicker, requiring more complex care.
In a press release sent out shortly before the Seven Days' story went online Wednesday morning, health network CEO John Brumsted said the hospital was doing everything in its power to address the crisis, from ramping up recruitment efforts to proposing new facilities.
"I hope this conveys the urgency we are feeling," he wrote. "But we also need to set realistic expectations. Many of these interventions will take time to work, and many require the approval of state regulators before we can proceed."
In a separate statement provided after the state's announcement Wednesday afternoon, Brumsted called the medical center's wait times "unacceptable."
"We have had many conversations with state leaders about these issues and are very grateful for their partnership and any assistance they can lend in removing barriers to progress," he said. "We will keep the public informed as our work moves forward."
Correction, September 2, 2021: A previous version of this story incorrectly identified a patient's diagnosis.