Big plans for Vermont: Proposal to build the state's second ASC

As healthcare becomes increasingly driven by consumer demand, ASCs are often a preferred option for patients. Amy Cooper and Tom Dowhan, MD, are hoping to build the second freestanding ASC in Vermont. If they are granted a certificate of need for the facility, it will serve residents in Chittenden County, the largest county in Vermont.

"This is not a new concept in the country or even in New England," Ms. Cooper says. "It is a new concept in Vermont. It is important for healthcare providers to come up with innovative solutions that make care more affordable for the consumer. In this day and age, high-deductible plans are becoming more commonplace and patients are having to pay more out of pocket, making a lower-cost ambulatory surgery center more necessary in Vermont."

Currently, physicians are performing all outpatient procedures in the county at the University of Vermont Medical Center in Burlington and are close to exceeding the hospital's capacity. When Dr. Dowhan and Ms. Cooper filed the CON application for the ASC, the hospital did not oppose the application.

"The hospital did a study on capacity and determined they were at or exceeding capacity across 12 specialties, many of which we are proposing to offer at our ambulatory surgery center," Ms. Cooper explains. "UVM Medical Center has not filed to be an interested party in the case and we are hopeful that means they recognize that the services we would provide would be a complement to the services they provide in the community."

New England currently has approximately 175 ASCs operating in the region, yet Vermont only has one ASC available for residents. To obtain the CON, the ASC's planners need to prove to Green Mountain Care Board that Vermont residents lack enough options for quality healthcare.

"You have to prove that surgeons aren’t able to provide timely, quality healthcare to patients with the current facilities and need an ASC," Dr. Dowhan states. "As the population ages, we are going to need to be more efficient and provide services in the most cost-effective way."

The approval process will take at least a year, although Dr. Dowhan predicts it could take up to a year and a half. Dr. Dowhan and Ms. Cooper are not sitting idly by waiting for the approval. Rather, they are educating the community on the importance and value of the ASC and to gather more support for the project. They are conducting meetings, brought in ASC consultant Avanza Healthcare Strategies to advise on the planning and have developed an LLC for the potential entity.

"We have a good case for why this is necessary for Vermont," Ms Cooper says. "We are confident the Board will understand that through this process."

The proposed center will be a multispecialty center offering gastroenterology, OB/GYN, pain management, general surgery and some orthopedics services. Dr. Dowhan is one of the owners and operators of Vermont Eye Surgery & Laser Center located in South Burlington. It is presently Vermont's only freestanding ASC.

Vermont Eye Surgery & Laser Center is a single-specialty ASC offering ophthalmology services. Dr. Dowhan has received positive feedback from residents who favor the convenience and reduced cost an ASC offers.

"We have had a number of patients say once they had their first surgery, they are looking forward to the next one," Dr. Dowhan says. "You don’t hear that very often about surgery."

Physicians across several specialties are working with Dr. Dowhan and Ms. Cooper to establish the ASC. The physicians realize the potential opportunities an ASC in Vermont would offer with the changing marketplace.  

"Some surgeons are eager to personally take initiatives to help make healthcare more efficient and affordable," says Dr. Dowhan. "One such initiative is to start an ambulatory surgery center. Efficiency allows them to increase productivity and decrease costs."

Dr. Dowhan and Ms. Cooper have several letters of support from community organizations. They are continuing to gather letters of support to prove Vermont is in need of another ASC. Ms. Cooper and Dr. Dowhan are hopeful their proposal will be approved and can proceed in the next step of the process — building the center. Until then, they will work tirelessly to get more support from community members.

"We welcome any community doctor who wants to use the center if we can accommodate them," Dr. Dowhan says. "We want to have as many people as possible who want to utilize and support the center."

More articles on surgery centers:
143k medical professionals oppose mass deportation of undocumented population — 4 things to know
The race for ASC efficiency and value: 4 ways to increase throughput and promote quality
ASC industry leader to know: Stephen Rosenbaum of Interventional Management Services

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