New law capping drug prices could force small hospitals to close specialized services
ST. ALBANS, Vt. (WCAX) – Critics of a new law aimed at reining in the cost of hospital drugs say that it could have unintended consequences that lead to the closure of some specialized clinics.
Mariah McSweeney suffers from hypermobile Ehlers-Danlos syndrome, a rare disease that affects the connectivity of her tissues and muscles.
“As a result, not only do I bend in funny ways, I also have a lot of health complications as a result of that,” McSweeney said.
She gets regular IV fluids and Tylenol at Northwestern Medical Center’s infusion clinic to manage pain and symptoms. She’s one of hundreds that use the St. Albans hospital’s clinic– instead of the ER — to manage everything from cancer to Crohn’s disease to other conditions.
“I’m not standing in the way of someone with a real emergency at the ED. This is very important — it’s not an emergency. At least not yet. The point is to avoid an emergency,” McSweeney said.
The drugs delivered to the clinic are expensive. Vermont leads the nation in hospital drug costs. To bring those costs down, Vermont lawmakers this spring passed a bill capping what hospitals can charge for outpatient drugs at 120 percent of the average sales price.
“Five of our most frequent medications, we’ll be underwater in terms of changing for them,” said Peter Wright, Northwestern Medical Center’s CEO.
He says they lose money on many inpatient services, and administering drugs is one of the only profitable procedures. Wright says following the new law could lead to the infusion clinic’s closure and force patients to leave the county for care. “That would be a big problem for our community.”
“We have enough money to deliver a great health care system. We already have it, we just have to use it properly and be efficient in our operations,” said Green Mountain Care Board Chair Owen Foster. He says the current system is unsustainable and that hospitals need to look into finding savings in administrative costs, consolidated services, or draining cash reserves before it comes to cutting care. “You have to prioritize patient care first. And only after you’ve done those other things should you really get into whether you need to cut a service.”
McSweeney says she’ll be able to find care if the center closes, but she says for others, access to the infusion center is a matter of life and death.
“These are the people who make sure we have food, make sure our homes are safe. The folks here are the lifeblood of the community,” she said.
Northwestern will soon submit its budget to regulators. Next year, they plan to use up about 40 days of cash reserves, bringing them to 161 days.
The health care cash struggle comes as the state is in a multi-year process — similar to that of right-sizing public schools — to deliver health care in a sustainable way.
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