It's Tuesday, September 15.

UVM Health Announces More Layoffs After Hospital Budget Cuts

The Green Mountain Care Board concluded its hospital budget reviews this week, a process “unlike any other in the country,” said Mike Del Trecco, the president of the Vermont Association of Hospitals and Health Systems (VAHHS). It approved budgets for the state’s 14 hospitals, reducing the prices hospitals can charge commercial insurers by nearly 3% statewide compared to this past year.

The biggest price cuts were targeted at UVM Medical Center, with a 4.4% reduction in commercial rates. Hospital president Stephen Leffler, MD, projected the budget will result in a $75 million loss, on top of a roughly $75 million deficit over the past year. “If this is the budget we get, we'll deal with it, but I am very concerned,” he said.

Earlier today, the hospital system announced plans to cut nearly 200 positions by next month, including over a dozen mental health technicians and patient safety attendants at Central Vermont Medical Center, according to reporting by Seven Days. A UVM Health spokesperson said the cuts were planned before regulators approved hospital budgets.

At the end of the budget hearing, Del Trecco told regulators, “I think every decision made today will further destabilize the financial outlook of our hospitals.” He warned that budget cuts will limit hospitals’ ability to invest in their workforce, facilities, and communities, and will not support improvements in access or quality. Here is a breakdown of budget decisions by each hospital:

  • 🏥 Brattleboro Memorial Hospital: The Board is temporarily allowing the hospital to keep its commercial rates flat until the hospital can resubmit its budget with more details. They also said the hospital could increase commercial reimbursement rates for perinatal, obstetric, and pediatric services by up to 350% of Medicare rates to support the hospital’s birthing center.
  • 🏥 Central Vermont Medical Center: The Board said the hospital needs to cut commercial prices by 1.7%, and the total revenue it generates from commercial payers by 2% because of budget enforcement actions. Board Chair Owen Foster pushed to give the hospital some reprieve, sharing concerns for their long-term viability and the “levels of reductions this fast.”
  • 🏥 Copley Hospital: The Board will require the hospital to cut commercial prices by 1% and commercial revenue by 1.2%, after the hospital originally requested more than a 5% increase in commercial rates.
  • 🏥 Gifford Hospital: The Board approved a 3.7% cut to commercial prices, and an 8.8% cut to commercial revenue, but an increase in its net patient revenue of 2.7%.
  • 🏥 Grace Cottage Hospital: The Board also approved a 1.4% cut to commercial prices, and .7% cut to commercial revenue. Board member Dave Murman, MD, praised the hospital’s attempts to reduce charges that are high outliers as “exemplary.”
  • 🏥 Mt. Ascutney Hospital and Health Center: The Board noted the hospital’s relatively high prices and approved a 1% reduction in commercial rates and revenue.
  • 🏥 North Country Hospital: The Board approved a 1.2% reduction in commercial prices and a 5% reduction in commercial revenue and will allow total revenue to grow 1.1% over last year.
  • 🏥 Northeastern Vermont Regional Hospital: While the Board acknowledged the hospital’s high prices, they said NVRH is struggling financially and continues to offer essential services like obstetric care. They approved a 1.2% cut to commercial prices, a .6% cut to commercial revenue, and a 2.1% increase in total revenue over last year.
  •  🏥 Northwestern Medical Center: Deviating from their guidance, the Board approved a 2% increase in commercial prices and revenue, and more than a 7% increase in total revenue. They justified this decision by saying NMC has some of the lowest prices in the state and wanted to give them more room to grow their services.
  • 🏥 Porter Hospital: The Board approved a reduction of “at least 1%” for commercial prices, and a 1.3% reduction in commercial revenue, allowing the hospital to grow total revenue by 3.3%.
  • 🏥 Rutland Regional Medical Center: The Board approved a 2.6% cut in commercial prices and a 1% cut in commercial revenue.
  • 🏥 Southwestern Vermont Medical Center: The Board approved a 2% cut in commercial prices and a 1% cut in commercial revenue, allowing for a 2.3% growth in total revenue over last year.
  • 🏥Springfield Hospital: The Board made a second exception to guidance, allowing the hospital to increase commercial prices up to 2% and grow net patient revenue by 8.1%, while cutting commercial revenue by 1.8%. The Board will permit the hospital to further increase reimbursement for inpatient psychiatric services by roughly $150,000 next year.
  • 🏥 University of Vermont Medical Center: After significant debate, the board decided to require the hospital to reduce commercial prices by 4.4% and cut commercial revenue by 1.3%. Chair Foster shared concerns about the hospital’s “ability to take such severe price cuts in such a short period of time.”

In addition, as part of the UVM Medical Center budget conditions, the Green Mountain Care Board will establish a working group “to provide greater transparency and oversight into the University of Vermont Medical Center’s financial support of the Larner College of Medicine." VMS weighed in on the proposal last week, asking that the board include practicing physicians and trainees in the discussions.

See the full GMCB presentation, press release, and recordings of the deliberations. 

    IN CASE YOU MISSED IT

    🎉 Candidate Receptions: Thank you to everyone who attended a legislative candidate reception in Burlington and Brattleboro, it was great to see you! We still have several more events in Newport, White River Junction, and Montpelier over the next few weeks. RSVP here for a chance to speak with candidates in an informal setting, catch up with colleagues, and enjoy free food:

    • Sept. 24 at East Side Restaurant in Newport
    • Oct. 7 at Thyme in White River Junction
    • Oct. 15th at Barr Hill in Montpelier

    💵 AHS Announces Rural Health Transformation Awards and Contracts: Vermont’s Agency of Human Services has released a “partial and ongoing list” of Year 1 RHT awards and contracts totaling nearly $65 million, including:

    • $9 million to the Vermont Student Assistance Corporation (VSAC) for financial assistance to students training in health-related fields who commit to working in rural Vermont communities for at least five years, including licensed nursing assistants (LNAs), emergency medical services, and nursing and dental hygienists
    • $8.6 million to Kinney Drugs to expand pharmacist test-to-treat in more scenarios and pay for a scheduling, documentation, and medical billing platform
    • $7.6 million towards expanding access to recovery housing for people with substance use disorder
    • $2.6 million to the Green Mountain Care Board for a data “modernization and transparency initiative”
    • $2.2 million for mental health and community support integration into primary care teams at several hospitals throughout the state
    • $500K+ to the Maple Mountain Consortium Family Medicine Residency Program

    📃 VMS Submits Comments on 2027 Medicare Physician Fee Schedule : VMS sent a letter to CMS last week asking the administration to bring Medicare physician payments more in line with rising practice costs by supporting congressional action to enact a permanent, inflation-based update to the fee schedule. VMS also shared concerns around a policy to apply a payment reduction for services furnished with a separately identifiable E/M visit (modifier -25); urged CMS to finalize changes to the Maternity Care Services CPT code set; and opposed cuts and new restrictions on remote monitoring services. CMS typically finalizes the fee schedule by Nov. 1 for Jan. 1 implementation each year. The schedule is important because Vermont Medicaid and commercial payers often follow the coding and policy changes adopted by Medicare.

    🏥 Vermont Hospitals Share Data on Efficiency, Access: The Vermont Association of Hospitals and Health Systems (VAHHS) developed a public-facing dashboard that brings together hospital finance, quality, efficiency, and access data, including the average time that patients spend in the emergency department, length of stay, and readmission rates for Medicare patients. The data provides a snapshot of how Vermont hospitals compare with one another and national benchmarks. “We’re showing all the data, good and bad, because we believe transparency is essential to improvement,” according to a VAHHS announcement.

    🫄 Maternity Care Billing and Freestanding Birth Center Updates: The American Medical Association (AMA) released guidance regarding upcoming changes to maternity care billing, which take effect Jan. 1, 2027. The revisions unbundle one “global” code that effectively represents nine months of care as a single service and allow care to be reported at a service level. As a reminder, Vermont Medicaid providers are expected to maintain standards for timely claim submissions. Claims should not be delayed or held based on the assumption that a denial may occur. In addition, VT Medicaid will soon release information regarding new coverage and the enrollment process for freestanding birth centers, in anticipation of the Vermont licensure rule adoption effective Jan. 1, 2027.

    😷 Long COVID Resources: The Vermont Department of Health recently updated their webpage for people who experience symptoms of COVID-19 four weeks or more after a severe illness. It lists several Vermont-specific support groups, including those offered by the Vermont Center for Independent Living, and the University of Vermont Medical Center. The updated were required by a state law that passed this year.

    🌐 National Government Services is Operating as Wellpoint Federal: Vermont’s regional Medicare contractor, National Government Services, is now named Wellpoint Federal and has a new website. You can continue to access the same online resources and services. Going forward, you will start seeing Provider Website in place of NGS Medicare and Provider Portal in place of NGS Connex.

    EVENTS

    Health Equity Summit

    Sept. 24 - 25 | Burlington

    The Health Equity Summit is a collaborative space for health care professionals, community leaders, researchers, and advocates to build partnerships in pursuit of a more just and equitable future. Free to attend. Click here for more information.

    Neurobiology of Trauma and SUD

    Wednesday, Oct. 7 from 12 - 2 p.m.

    This session uses findings from addiction and trauma research to highlight how substance use disorders and exposure to traumatic stressors can produce neurobiological changes that influence behavior and contribute to overlapping clinical needs in recovery. Learn more and register.

    ACP Vermont Chapter Annual Scientific Meeting

    Friday, Oct. 9 | Stowe, VT

    The Vermont ACP Chapter's Annual Scientific Meeting is scheduled for Friday, October 9, 2026. We will again host a poster competition for resident and student members. Please visit the Meeting Hub for registration and agenda. 

    2026 Collaborative Meeting

    Nov. 13 - 14 | Stowe, VT


    The 2026 Collaborative Meeting is taking place at Topnotch Resort in Stowe. Meet your colleagues and hear timely updates from health care leaders. See the full agenda and register here.

    For more information about offerings from UVM Continuing Medical and Interprofessional Education, visit this link.

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    Vermont Medical Society

    PO Box 153

    Williamstown, VT 05679

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