Years later, proposed surgical center still pending

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Nearly two years after filing a certificate of need, the lead representative of the proposed Green Mountain Surgery Center in Colchester says she expects to hear a verdict from the state’s Green Mountain Care Board by summer’s end.

“We knew it was going to be a long process from the outset,” said Amy Cooper, executive director of HealthFirst and a primary planner of the project. “[But] if I don’t have news by August, that will be worrisome.”

Applicants filed for a multi-specialty ambulatory surgical center to be located at 535 Hercules Dr. in Colchester on July 2, 2015, saying it would improve patient experience and lower costs.

The facility could provide “elective, non-emergent” services in gastroenterology, obstetrics and gynecology, orthopedics procedures and more, the application said, at a lower rate than area hospitals.

Ambulatory surgery centers, prominent in other areas of the country, receive Medicare reimbursement at roughly 45 to 60 percent of the rate given to hospitals for the same procedure, the application said, often used as a “guide star” for setting private pay, Medicaid and third-party payers’ rates.

Cooper formed the applying company, ACTD LLC, in 2014 with Dr. Thomas Dowhan and “in consultation with local physicians.” Most members of the latter group intend to perform surgery at the proposed center.

All new health care projects in Vermont must obtain a certificate of need from the GMBC, according to the state website, a measure “intended to prevent unnecessary duplication” and promote cost containment, among other aims.

The Vermont Association of Hospitals and Health Systems and Northwestern Medical Center in St. Albans have each submitted opposition briefs to the GMCB, stating they would be negatively impacted by the center.

In an op-ed piece published in the Sun earlier this year, NMC CEO Jill Berry Bowen said her hospital could lose $1 million if “the proposed for-profit surgery center drew off colonoscopies by promising insurance companies lower prices than NMC.”

“NMC would still have to run our operating rooms; we would just do so less efficiently,” Berry Bowen wrote. “That means even more cost shift, so the prices for other services go up.”

Deliberations were most recently delayed when two of the five GMBC board members left their posts, leaving Cornelius Hogan, Jessica Holmes and Robin Lunge to hold public meetings as a trio.

A staffer in the GMBC office said board members could not comment on any active applications, but a notice posted filed on the board site on May 12 said the three remaining members could not come to a consensus on the proposed center.

Citing statute that requires a consensus by the majority, the members announced they would wait for the vacant seats to be filled before issuing a decision.

Weeks later, Gov. Phil Scott announced two appointments to the board: Kevin Mullin, a longtime Republican state senator from Rutland, and Maureen Usifer, a Colchester resident and former CIO of Seventh Generation Inc.

“I am excited by the opportunity to serve Vermonters and work with my fellow board members to ensure Vermont continues to lead on access to healthcare, while ensuring the system is affordable for the state and all Vermonters,” Usifer said in a press release from the governor’s office.

Usifer presently serves on the board of directors and is chairman of the audit committee at BlackRock Capital Investment Corporation, the release said. She is a trustee at St. Michael’s College and serves with the Green Mountain Higher Education Consortium.

Both appointments were effective May 24, according to the release from Scott’s office.

The center applicants have since submitted a written request for the opportunity to answer questions posed by new members Mullin and Usifer in person, calling it the most “effective and efficient way to ensure that the Board’s concerns and questions are fully addressed.”

Both NMC and the Vermont Association of Hospitals and Health Systems opposed that request in a June 5 email, calling the application’s record “complete.”

“There has been ample opportunity to submit public comment,” the email said. “Should the new members have questions, they can easily be answered in writing.”

Last Friday, Cooper said she hadn’t heard an answer from the board regarding the request. Their next meeting was scheduled for June 15, according to the state’s website.

In the meantime, Cooper said the local landowner has kept the lease option on the table. If approved, the facility’s construction is estimated to take eight to 10 months, she said.

“We are excited about the possibility of opening in Colchester,” she added.

More information on the project is available at http://gmcboard.vermont.gov/con/pending/Gr-Mt-Surgery_Ctr.