Vermont Business Magazine Today, the Green Mountain Care Board (GMCB) voted to approve a comprehensive settlement agreement with the University of Vermont Health Network (UVMHN) and the University of Vermont Medical Center (UVMMC), resolving matters related to significant budget overages in Fiscal Years 2023 and 2024 and outlining a path forward for system-wide financial accountability and healthcare reform.
The agreement reflects a shared commitment to promoting financial sustainability while preserving access to high-quality, affordable care for Vermonters. It resolves pending legal appeals and sets in motion a series of actions and investments aimed at system improvement, transparency, and accountability.
“This agreement is an important step toward system-wide improvements at the University of Vermont Health Network, including through restoring trust and driving lasting improvements in Vermont’s healthcare system,” said Owen Foster, Chair of the Green Mountain Care Board. “It reflects our mutual responsibility to put patients and communities first while building a more sustainable future.”
Key elements of the settlement include:
- Primary Care Investment: UVMMC will invest $11 million in non-hospital primary care services in FY26.
- Resolution of Blue Cross Blue Shield Allegations: UVMMC will pay $12 million to Blue Cross Blue Shield of Vermont as part of resolving FY22 and FY23 overpayment disputes.
- Independent Consultant-Led Reform: Up to $15 million will be invested in third-party, independent consultants and independent Liaison to assess operational efficiencies, governance, shared services, and clinical service line optimization across UVMHN. Any unspent funds may be directed by the Green Mountain Care Board to further the goals of the agreement, including additional efforts to support primary care providers and promote affordable commercial insurance for Vermonters.
- Executive Compensation Reform: At-risk compensation for senior executives in FY26 will be directly tied to performance in key areas, including performance improvements by New York hospitals within UVMHN’s network, reducing emergency department utilization and maintaining commercial revenue growth within benchmarks.
- Transparency and Budget Compliance: UVMMC will take mid-year actions in FY25, if necessary, to comply with its budget order and will submit a FY26 budget that adheres to GMCB benchmarks.
In return, GMCB will amend its FY23 enforcement order to spread the remaining commercial rate reductions equally over FY26 and FY27 and will decline to take enforcement action related to the FY24 overage. These actions are contingent on UVMMC dismissing its pending appeals related to the FY23 enforcement and FY25 budget orders.
A workgroup—including GMCB members, trustees from UVMHN and UVMMC, and an independent Liaison—will oversee the consultant process and provide reports to ensure alignment with the goals of the settlement. The full text of the approved settlement agreement can be found here.
About: The Green Mountain Care Board (GMCB) is a 5-member, independent Board with a vision of a sustainable and equitable health care system that promotes better health outcomes for Vermonters. GMCB was created in 2011 with a mission to drive system-wide improvements in access, affordability, and quality of health care to improve the health of Vermonters. Through public meetings, GMCB ensures a transparent approach to health care regulation and a voice for stakeholders, including health care organizations, clinicians, and members of the public. With a holistic, data driven approach, GMCB carries out its regulatory duties, supports innovation in health care delivery and payment reform, and serves as an important resource for independent, transparent analyses of Vermont’s health care system performance.
4.4.2025. Montpelier, VT – Green Mountain Care Board
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