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UVM Medical Center Submits Plan for New Outpatient Surgery Center to GMCB

Project Responds to Emerging Challenges Tied to Region’s Rapidly Growing, Aging Population

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Burlington, Vt. – The University of Vermont Medical Center today submitted a certificate of need (CON) to the Green Mountain Care Board for a multispecialty outpatient surgery center (OSC) to be located at its current Tilley Drive campus in South Burlington. The new facility will help meet the need for surgical services for an aging and growing population in the hospital’s service area 

“Population forecasts show that by 2030, the total population in our service area will grow by 4 to 8 percent, and the 65-plus population will grow by 30 to 60 percent. We already see that our patients face access challenges, and a growing and aging population only exacerbates those challenges,” said Stephen Leffler, MD, UVM Medical Center President and Chief Operating Officer. “We will need more capacity to meet the health care needs of the people we serve.” 

The new surgery center will increase the UVM Medical Center’s surgical capacity by initially adding eight operating rooms, 12 prep rooms, and 36 recovery spaces, which will include eight extended-stay recovery rooms. The setting will promote efficiency and better experiences for patients, families, surgeons and staff, and will include space to add additional operating rooms if needed in the future. 

The project will also allow UVM Medical Center to shift all surgeries from its Fanny Allen operating rooms, which cannot be expanded or further updated. The project is estimated to cost $130 million.

UVM Medical Center expects the center to have the capacity to perform approximately 8,000 outpatient surgeries per year, directly addressing growing local and regional demand for these services. Demand for outpatient care – in particular – is growing. Outpatient services mean less time spent at the hospital and allow patients to more quickly return to their lives and convalesce at home.

Leaders from both UVM Health Network and UVM Medical Center, which is the region’s only tertiary care facility and serves approximately 1 million people across Vermont and northern New York, called the project a key step in plans to address challenges around patient access and financial sustainability both at the hospital and across the Health Network.

“UVM Medical Center is a cornerstone of our region’s health ecosystem and must invest in new, modern facilities to meet the needs of patients now and in the future,” said Sunil “Sunny” Eappen, MD, MBA, UVM Health Network President and CEO. “Proceeding with this project makes financial sense, both in the face of our most immediate financial challenges and our ability to provide the highest quality care for our population for the long term. This project will directly benefit patients throughout Vermont and northern New York.”

“In addition to its positive health impacts, this project will also help ensure that UVM Medical Center is financially secure in the future so that we can continue our mission,” Dr. Leffler added.

The Need: Growing Demand, Aging Facilities

Even before the pandemic, UVM Medical Center has consistently operated at capacity and faced sustained access challenges. The issues beleaguering Vermont’s largest health provider are expected to grow worse over time, according to UVM Medical Center planning documents — largely driven by Chittenden County’s population not only rapidly growing, but aging at the same time.

With this demographic change driving increased demand for outpatient surgical services, the UVM Medical Center expects its current surgical capacity to fall short of demand by nearly 4,300 cases — or about one year’s worth of Fanny Allen surgeries — by 2030.

Additionally, UVM Medical Center’s current higher average “age of plant” reflects that the Medical Center is falling behind in its reinvestment into facilities. The Fanny Allen’s aging OR is an example of where reinvestment has been deferred but now requires our attention.

“These complex, in-demand procedures could be performed more quickly and efficiently in a modern, outpatient setting,” said Dr. Leffler. “That transition will also free up additional capacity in UVM Medical Center’s inpatient operating rooms. It’s a move that supports both our patients and our skilled and dedicated care teams, but time is not on our side. We have an imperative to act now to ensure we can continue to effectively carry out our mission of caring for patients across our region.”

The new OSC could be operational approximately two years after a certificate of need is approved.

Faculty and Staff Impacts

The new OSC facility would be located at the UVM Medical Center’s current Tilley Drive Campus in South Burlington, and will feature easily-accessible parking for patients and staff, as well as public transit service.

In addition to the eight operating rooms, pre- and post-operative spaces and extended recovery spaces, it will also include a Mako robot for orthopedic joint procedures, which Claude E. Nichols III, MD, UVM Medical Center Orthopedic Surgeon and Chair of Orthopedics and Rehabilitation at the Larner College of Medicine called a critical aspect of advancing joint care for older patients throughout the region.

“In orthopedics, a major change in the past several years has been the evolution of procedures that previously required a hospital stay to be performed as outpatient procedures in the appropriate patients,” said Dr. Nichols. “As people live longer and remain more active later in life, procedures like joint replacements are a growing, critical need — and so is ensuring our patients return home as quickly and safely as possible.”

To address longer-term needs driven by the region’s ongoing demographic changes, the OSC facility will also include undeveloped space that can be used to add four additional operating rooms and 14 pre- and post-operative spaces in the future, if the initial operating rooms reach capacity within a decade, as they are projected to do. Building the exterior shell for these additional spaces with the initial facility construction will greatly reduce the impact to current operations when additional capacity is needed, permit interior construction regardless of the time of year, and provide this additional capacity at a lower total cost.

The new facility will need 166 employees to support daily operations. While most will transfer from other areas of UVM Medical Center’s operations, the organization will begin active recruitment and workforce development initiatives at least 18 months before the facility sees its first patient.

One aid in the recruiting effort will be the facility itself. Designed with input from providers and staff, and equipped with advanced technologies and equipment, the proposed OSC facility will be a highly desirable environment for health care professionals to work.

Finances and Affordability

The facility’s $130 million price tag reflects the size and complexity of the project and includes site acquisition and preparation, design, construction and medical equipment purchases. Nearly three-quarters of the cost — $100 million — of the funds will be secured through borrowing.

It is not anticipated that borrowing for this investment will negatively impact the UVM Health Network’s current financial health or its bond rating.

Once built and fully operational, the outpatient surgery center is expected to contribute to the financial health of UVM Medical Center, as well as offset the many services that incur financial losses for the organization.

“This is a critical step in the right direction, at a time when hospitals across our region — including UVM Medical Center — have faced financial challenges due to a variety of factors, including persistent inflation,” said Dr. Leffler.”

“Our team views this as something that we cannot afford not to do for our patients and the ongoing sustainability of health care in Vermont,” Dr. Eappen concluded.