BENNINGTON -- People in immediate need of a doctor -- but who don't need the emergency room -- may have another option this fall.

James Trimarchi, director of planning at Southwestern Vermont Health Care, said Friday that $1.5 million in renovations to Southwestern Vermont Medical Center's medical office building will result in more exam rooms, better patient flow, and space for a "same-day clinic."

"It's really directed at people with primary care issues that are not for the emergency room," he said.

The clinic has yet to be dubbed with an official moniker, but the hospital believes it will have one doctor assigned to it, and a number of nurse practitioners. It will be open into the evening hours seven days a week and work like a normal primary care office.

Trimarchi said there are many people who need some kind of immediate care, be it for pink eye, bladder infection, or child's earache, who have a primary care doctor but can't get an appointment right away. Many of these patients go to the emergency room, which can get flooded at times, is twice as expensive, and needs to divert energy to critical cases.

The plan is to have the same-day clinic up and running by fall.

Trimarchi said the renovation work did not require approval from the Green Mountain Care Board as it did not exceed $3 million, but that the board did have to be notified.

He talked about the same-day clinic at a Bennington County Regional Commission meeting on Thursday, during which also said there are early plans in the works for a primary care provider to be set up in Pownal.


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SVMC already has such offices in Manchester and Wilmington. Trimarchi said the Southwestern Vermont Health Care Board of Trustees has not yet approved the Pownal office, which makes it quite early in the planning stages, but the goal is to have it close to the Massachusetts border.

With the recent closure of North Adams Regional Hospital in North Adams, Massachusetts, SVMC has had to take steps to handle patients not going farther south for their care. Having a campus closer to that area may help. Trimarchi said SVHC, the parent company of the Bennington hospital, has hired 20 former NARH employees.

If plans for a Pownal campus are approved, it would be comparable to the Wilmington office, and completed sometime in the summer of 2015, said Trimarchi, who told the BCRC group that renovations to the hospital's Manchester facility are complete and that it will allow more doctors and health providers to work out of there.

He said these are examples of how the hospital is working to improve the delivery of care. Payment reform is another matter. Trimarchi said the current fee-for-service model being used means that the sicker a community is, the better a medical provider does financially. Elements in the Affordable Care Act are seeking to change this, and SVMC is participating in OneCare Vermont, a statewide accountable care organization. Under it, doctors have agreed to keep the cost of health care under a certain price. If they do so, they split what gets saved with Medicare.

Trimarchi said the care has to meet standards and criteria, and work to improve and expand it is ongoing. The goal is to ultimately have medical providers benefit from keeping a population healthy rather than profit from it being ill.

Contact Keith Whitcomb Jr. at kwhitcomb@benningtonbanner.com or follow him on Twitter @KWhitcombjr.