Q & A with Trustees

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Taking Stock: A Conversation with Trustees John Powell and Gretchen Morse

Gretchen Morse and John Powell serve on the Boards for Fletcher Allen and Fletcher Allen Partners.  John is chair of the Fletcher Allen Board Finance Committee and Gretchen is chair of the Planning Committee. Recently, we sat down with them to discuss Fletcher Allen’s finances, health care reform and how all of this may impact our future.


A:  John: First, on a very personal level, this organization has been an important part of my life.  My dad was a doctor here for many years, my mom was a nurse, my sister is a midwife and her two kids are both doctors.  So there’s a sense of family that is a part of my experience here.  Additionally, having had a business in this community for 20 years, I know the value of this institution – as an economic driver for the state and its tremendous value to the community. 

Gretchen:   I consider it an honor and a privilege to serve on the Board.  I’ve been following the journey of this organization for the last 40 years - at the state level, when I was elected to the Legislature in 1976 and later chaired the Health and Welfare Committee; as former secretary of the Vermont Agency of Human Services; and, as former executive director of the United Way, when I really came to appreciate the enormous resource that Fletcher Allen is to the non-profit sector.  This organization provides a strong network of services and alliances, filling so many needs in our community.   I’m very pleased to play a role in helping this academic medical center focus on staying current and vibrant, and building on our strengths.


Q: We often hear about how health care reform will affect businesses and families.  What’s the impact on Fletcher Allen, the state’s academic medical center?

A: John: In some respects, it’s what we don’t know that is the bad news.  We know that change is coming; we’re just not sure what it’s going to look like.   But there’s some good news as well – because  the prospect of change has driven our communities to think outside their local perspective.  And what we are all coming to realize is that collaboration is the key to our success.

The collaboration we are looking at would allow hospitals to maintain their individuality, so that the functions of each institution are tailored to the needs of the community they serve. Along with that, health care reform is driving a search for greater consistency in our performance – just as a great restaurant aims to serve a great meal every time, we want to create great patient experiences every time. It’s a big challenge, but even more important as health care reform unfolds.

Gretchen:  As the region’s academic medical center, improving quality, access and reducing costs have always been a focus.  But with the changes that health care reform may bring, we’re going to need to rethink how we do things so that we can continue to improve quality and access and reduce costs.  We are in a key leadership position to be innovative and flexible, and I have tremendous confidence that we’re making good decisions. That said, with all the uncertainty that health care reform brings, we also need to educate and advocate for what will help this organization continue to meet the needs of the region.


Q: How do you see health care reform affecting the organization’s strategic priorities and capital investments?

A: John: First, health care reform is driving our strategy to build an integrated delivery system.   It is also driving the way we look at our capital investments.  For example, many of our inpatient facilities are outmoded, and we are looking at our inpatient beds.  As we do this, we’re also asking: where is the appropriate level of care being given?  What is the best place for this patient? 

Another key piece of health care reform is investment in information technology, to support quality improvement efforts.  Our investment in our electronic health record is an important part of our efforts to improve quality, and that investment is paying off.   All of these conversations are being shaped by health care reform.

Gretchen: As members of the Board for Fletcher Allen and Fletcher Allen Partners, we have an obligation to be accountable to the strategic direction of the organization.  We’re very pleased to see how we are building partnerships with regional hospitals, and are proud to be a part of our partnership with Central Vermont Medical Center and our budding relationship with CPI.  I’ve been so impressed with the breadth and depth of our discussions with our partners around the region – it’s something I would never have imagined 10 years ago.


Q: When it comes to Fletcher Allen’s fiscal health, what keeps you up at night?

A: John:  Not all players that have influence understand all the issues that are swirling around.  And that’s dangerous.  Fletcher Allen is a triple-B-rated institution.  This means that we have an “adequate” capacity to meet our financial commitments – but our finances are not strong enough to sustain significant risk.  An organization of this magnitude should have an A-rating – which would mean that we are in a greater position of strength to meet our financial commitments.   So we have to be cautious.  We have to educate our community, to build an understanding of our financial position and the risks – and build on the trust that we’ve earned over these past several years.

Gretchen: When you consider that we have a federal government that is an unpredictable reimbursement source, and that the state is going through changes, there are plenty of things to keep us up at night!  But I think that if we continue to make decisions focusing on quality and results, we will do well.  As  Board members, we’re trying to be reasonable about what’s best for Fletcher Allen in the context of forces that are not under our control – and that’s a huge challenge.   But it’s also a great opportunity.  I’m really impressed by the leadership here – and Fletcher Allen is a forward-thinking institution.  People look to us as a model on many levels, and I have confidence that this will continue in the future.