Chris Towne: Maintaining a strong primary care and home health network in the Northeast Kingdom

This commentary is by Chris Towne. He is chief executive officer of Northern Counties Health Care, headquartered in St. Johnsbury.

Every Vermonter deserves access to the health care services they need to live, work and age in our Vermont communities. After years of flat or declining funding amid rising costs, primary care and home health organizations have reached the point where they must make tough decisions about how and to what degree they can maintain primary, preventive and safety net services in their communities. These decisions will most acutely affect Vermonters living in rural areas like the Northeast Kingdom. 

Northern Counties Health Care has been a cornerstone of care for the region since its establishment when the Comprehensive Planning Council opened its first Federally Qualified Health Center in Island Pond in 1977. A decade later, NCHC merged with Caledonia Home Health Care & Hospice which had been caring for Vermonters in their homes since 1968. 

Northern Counties Health Care now serves over 25,000 Vermonters annually through a robust network of five primary care sites with integrated behavioral health services, three dental clinics, two walk-in care facilities and a Medicare Certified Home Health and Hospice agency. As a primary provider of health care services in the Northeast Kingdom, NCHC is committed to delivering high-quality, patient-centered care across these diverse areas, ensuring access to essential health services for all who need them. However, maintaining this comprehensive network is becoming increasingly financially unsustainable. 

Federal rate cuts, stagnant reimbursement rates and rising wages and supply costs are putting immense pressure on the robust care we deliver to Vermonters. The federal grants we receive to reduce financial barriers for our underinsured and uninsured patients have not increased in a decade. Inflation and the costs associated with delivering care continue to rise. The reimbursement we receive from commercial and government payers falls short of covering the true cost of providing primary care and home health services — some of the most underfunded areas in health care.

NCHC is unwavering in its commitment to the Northeast Kingdom. We strive to provide accessible, high-quality care to every individual and family in our region. This goal is increasingly difficult to attain as the gap between costs and reimbursement widens. 

Addressing this challenge requires action. Policymakers must prioritize fair and sustainable reimbursement rates to ensure the long-term viability of primary care and home health services. Communities can support local health care by advocating for better funding and policies that recognize the value of comprehensive, integrated care.

While we acknowledge the challenges of tight state budgets and the collective desire to lower taxes and insurance premiums, it is important to recognize that investments in home health, primary care and preventive services are practical and cost effective. These investments reduce expensive hospitalizations, emergency care, and long-term health costs, ultimately saving taxpayer dollars and reducing financial burdens on the healthcare system while improving health outcomes for Vermonters. 

Together, we can create a health care system that reflects the resilience and strength of the Northeast Kingdom. By investing in primary, dental, behavioral health and home health services, we can improve and sustain a model of rural health care that serves as a beacon of excellence. The Northeast Kingdom deserves nothing less. 

Read the story on VTDigger here: Chris Towne: Maintaining a strong primary care and home health network in the Northeast Kingdom.