The University of Vermont Health Network moved today to shore up one of its most glaring weaknesses when it appointed Anya Rader Wallack Senior Vice President for Strategic Communications.
Wallack, who was the architect of Vermont’s health care project, will become the fifth member of CEO Dr. John Brumsted’s top management team; the others are Al Gobeille, who is Senior Vice President for operations; Rick Vincent, the chief finance officer; Dr. Claude Deschamps, who leads the network physicians; and Eric Miller, the general counsel. Wallack will replace Theresa Alberghini DiPalma, who has resigned.
“I believe the American health care system is in crisis and can only be fixed by people who have a clear vision for reform and are in a position to improve it,” Wallack said in network press release. “I have dedicated my professional life to
improving our health care system and keeping it affordable,” she said. “The UVM Health Network has an extraordinary leadership team. I share their vision and values and am excited to join them.”
Wallack will receive a base salary of $400,000 per year, and will take over a major responsibility in the network, which is the one of the most important health care providers in the region, along with Dartmouth-Hitchcock in New Hampshire and Maine Medical in Portland. The UVM group is made up of six hospitals in northwest Vermont and northeastern New York. The network deploys more than 1,500 doctors and other providers across the region, and serves more than a million patients a year.
The UVM network along with the university’s College of Medicine is arguably the most valuable asset that the state has, not only medically but economically, but it has been routinely denigrated by a witches brew of opponents—Chittenden County progressives, who hate anything big; major portions of the primary care physician community; many of the small hospitals, who see the 500-bed UVM Medical Center as threat to them; the state auditor who attacks the state’s Accountable Care Organization; skeptical treatment by the Green Mountain Care Board, biased press coverage….
Reversing the negative narrative around the UVM network will be Job One for Wallack. Can she do it?
Job One
No one can be sure about that, but I offer the following assessment to my tiny corps of brilliant readers:
Wallack is a very unusual player, and Brumsted’s ability to bring her on board the network ship is a brilliant stroke. So, what does unusual mean? And a “brilliant stroke” why? Stay with me here:
The health care reform movement arose in Vermont about 1983 and followed a wandering track from then until around 2010-2011, when it accelerated dramatically in the wake of federal Obamacare and former Governor Peter Shumlin’s Single Payer initiative. Over that period, a total, a very generous total, of maybe 25 or 30 people actually understood how the health care system works and what it might take to reform it.
Of that cohort, a tiny handful, meaning mid to low single digits, could be considered national class players in the reform space. Anya Rader Wallack is one of those; John Brumsted is another.
Wallack grew up in Bennington, and went to UVM, graduating in 1988. Her first important job was with Kimbell and Sherman, a new lobbying firm and Wallack’s flawless management of the back office functions there helped the firm grow to its dominant position.
Her first big break occurred almost at once. In August of 1991, then Gov. Richard Snelling died unexpectedly, and was succeeded by Lt. Gov. Howard Dean. Dean was very close to Kimbell and Sherman politically, and when the new Governor had to scramble to assemble a staff, Kimbell and Sherman agreed to let Wallack go. She started out as deputy chief of staff, at 25 years old. And she didn’t just step into the routine minutiae of the governor’s office: Dean had inherited a major health care reform initiative, and he turned it over to Wallack. He also hired a tough, experienced health policy expert named Rachel Block and the two of them steered the first big health care reform project into the Legislature. At the same time, First Lady Hillary Clinton was putting together national reform effort, and Wallack served as one of Clinton’s state level advisors.
The reform movement that crested in the mid-1990s failed in Vermont, as well as nationally and in the half dozen states that were in the reform vanguard. In the wake of the crash, Wallack left Vermont for a hospital job in Oregon. Reform would be dead for a political generation, but for Wallack, at 29 years old, the experience would turn out to be invaluable. In the early ‘aughts, she earned a Ph.D. in social policy from the Heller School at Brandeis University, one of the premier academics centers on health policy.
She brought that extensive background to bear in 2011 when she led the Shumlin Single Payer initiative to passage and then served as the first chairperson of the newly-formed Green Mountain Care Board. Her first move there was to write a one-page memo to a federal Medicare official outlining the Vermont reform approach, a foray that put the state at the top of the reform effort nationally. The second thing she did was to get in touch with John Brumsted, the CEO of the Vermont Health Network to begin working on reform. No reform was possible then, or is possible now, without leadership from the UVM system, which delivers half of all the care in Vermont.
She left Vermont in 2014 for personal reasons, before the single payer aspect of Vermont reform imploded, working at high levels first in the Rhode Island state government, and then at Brown University before deciding to come back to Vermont for a final effort to reform to full maturity. To repeat: Can she do it? Well, neither broad experience nor matchless credentials can ensure success. Still, getting one of Vermont’s best ever players back on the field has to be a plus.
I said at the outset that the Brumsted’s addition of Wallack would shore up the UVM Network’s most glaring weakness. That weakness has been a stunningly inept performance in managing its own environment. UVM Medical Center hospital has the best quality and financial performance in the state. None of the 13 other hospitals in the state can match the 500-bed tertiary academic facility in Burlington. Eight of the 13 have 25 beds or less, the rest are relatively small; only Rutland, Bennington and Central Vermont should be considered full service hospitals going into the 21st century, when American medicine gets more expensive and more complex every day.
The anti-UVM narrative has flourished over the last five years with no effective response. It is true, of course, that much of the criticism of the academic medical center is unfair, misguided, dishonest…but UVM during that period has had on its payroll a multi-million dollar public affairs apparatus that just never worked.
If you’re looking for evidence for that, you might consider the contrast between the political environment in northeastern New York and Vermont. In New York, the hospitals just across the lake simply asked UVM to take them over and solve their financial problems. UVM did so, and Brumsted became a hero in New York. When he realized that the failing 40-bed hospital in Ticonderoga couldn’t be saved, he gutted the facility and turned it into a clinic with strong primary care and a state-of-the art emergency room. Given the assurance that UVM would watch over the place, the New York state health department ponied up the $15 million needed to do the work.
In Vermont, in the face of a withering campaign of vilification, Brumsted has become Satan.
Turning that around is critical both for UVM and the cause of reform in Vermont.
For Anya Rader Wallack, that is Job One.