by Mike Del Trecco, CEO, VAHHS This week, Vermont’s hospitals are in the spotlight as the Green Mountain Care Board begins its annual hospital budget hearings. And it may not be an overstatement to say that the stakes have never been higher. Health care costs are under scrutiny from every angle, and Vermonters are feeling the pressure. Headlines have highlighted premium increases approaching $50,000 for some families. That’s simply unacceptable. And it reinforces what we’ve been saying for some time now: affordability is not just an abstract policy goal—it’s essential to access.
At VAHHS, we know that hospitals are stepping up to meet this moment. Behind every budget submission is a deep sense of responsibility to patients, staff, and communities. Hospitals are not just balancing the books; they’re making hard choices about how to sustain services, support their workforce, and remain available when Vermonters need them most. You’ll read several stories in the top section of VAHHS Update this week about specific services and staffing changes many of our hospitals are making to meet the moment and trim costs where they can responsibly do so. These changes are reflected in their budget submissions and will likely be discussed in detail at the hearings.
Make no mistake: these FY 2026 budgets are very lean, with some hospitals submitting budgets with negative margins. But they are thoughtful and responsible, centered on what matters most: patient care and affordability. Hospitals have gone line by line, identifying administrative savings, holding off on growth, and, only when absolutely necessary, considering reductions in services or staffing. These are not decisions made lightly. They are made with compassion and an eye toward minimizing disruption.
The early look at the systemwide data speaks volumes:
- Net patient revenue growth came in at 2.17%, below the GMCB’s guidance of 3.5%.
- Operating expense growth is at 3.36%, only slightly above the 3% target and down significantly from the 8.88% approved increase of recent years.
- The average rate increase requested is just 0.81%, one of the lowest on record.
These numbers reflect not only budget discipline, but also a clear response to public concerns and policy signals. Hospitals heard the call for action, and they’re delivering. I hope as you follow along the process, you’ll agree.
These numbers reflect not only budget discipline, but also a clear response to public concerns and policy signals. Hospitals heard the call for action, and they’re delivering. I hope as you follow along the process, you’ll agree.
But we must also be clear: transformation takes time. The structural challenges facing our state are massive – an aging population, housing instability, long-term care gaps, and mental health shortages – and don’t resolve with a single budget cycle or piece of legislation. Hospitals remain the safety net, the provider of last resort, always open and always available. That’s not ideal for patients or providers and it’s certainly not financially sustainable when there are more appropriate and lower cost options.
In the meantime, Vermont’s hospitals continue to show that we are leaning in with courage, competence, and compassion. As we start the hearings, I want to thank our hospital leaders and staff across the state. Know that your work is not only being seen it’s making a difference.
Vermont Association of Hospitals and Health Systems
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