MM Curator summary
The quick hiring of the VT Medicaid director by a hospital system has raised a few eyebrows.
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.
For the past four years, Cory Gustafson oversaw the state’s Medicaid program, which provides funding to doctors and health care facilities. Now, he’s taken a job at Vermont’s largest health care organization.
Gustafson, whose last day as commissioner of the Department of Vermont Health Access was May 28, started June 1 at the University of Vermont Health Network as network director of strategic and business planning. In his new role, he will develop “long term capital plans and strategies” for the organization, which serves about half of the state’s patients, according to spokesperson Neal Goswami.
Gustafson said the move from state government to an entity that relies on state funding doesn’t represent a conflict of interest because he will focus on “internal-facing” issues such as business planning, capital planning and increasing efficiency within the six network hospitals in Vermont and New York. The role allows him to abide by ethics rules that prohibit lobbying for a year after leaving state government, he said.
“This being an internal-facing position, I don’t see that being a problem,” he said of potential ethical conflicts. Upon deciding to leave state government, he said, he looked only for jobs “that would not run afoul of” the rules.
Goswami said Gustafson’s responsibilities “will not involve representing the Network before the state of Vermont, or any public and regulatory bodies.” The network spokesperson highlighted Gustafson’s “deep experience and knowledge in health care” and said that the new employee was “committed to following all state policies.”
It’s not the first time the hospital has recruited former state officials from the Agency of Human Services. In 2019, the Health Network hired Al Gobeille, former chief health care regulator of the Green Mountain Care Board and former secretary of human services, as its executive vice president for operations.
Prior to joining state government, Gustafson represented the health care industry before the legislative and executive branches. From 2011 to 2013, he worked as a lobbyist for the Vermont Association of Hospitals and Health Systems. After that, he lobbied on behalf of Blue Cross Blue Shield of Vermont.
Gov. Phil Scott appointed him commissioner in January 2017.
As head of the Department of Vermont Health Access, he was responsible for running the state Medicaid program, which provides health insurance for low-income Vermonters — and pays hospitals for those services. The department also manages the state’s health insurance exchange.
Most of the department’s day-to-day interactions with UVM Health Network were conducted by his subordinates, Gustafson said. However, he worked with the network on its role in the all-payer model, the state’s effort to change the way health care is financed. Vermont’s Medicaid program is a participant.
When it came to speaking with his future employer, “I had health care reform conversations, but that’s about the extent of it,” Gustafson said. He recused himself from those conversations after applying for the job, he said.
A large hospital’s interest in hiring a well-connected state official makes sense — and often pays off, according to Mike Fisher, Vermont’s chief health care advocate. Fisher said he was speaking generally and not specifically about Gustafson’s or Gobeille’s employment.
“Even if you have to wait a year, you have a person who really knows the ropes and has the relationships,” Fisher said.
Still, he said, “there’s a problem” with “the general flow from state government into an entity that’s regulated by state government.”
“There’s a concern about the integrity of the position,” Fisher said.
As a cabinet member, Gustafson said, he signed the executive code of ethics that bars officials from lobbying for one year after leaving their posts. He said he had no plans to move into a lobbying role even after the requisite time has expired.
But, he added, “Who knows what the future brings?”