Vermont lawmakers hear alarm: Green Mountain Care Board, AHS and hospitals say system ‘in crisis,’ urge rapid transformation

Jessica Holmes, a member of the Green Mountain Care Board, told a joint meeting of the Senate Health & Welfare and House Healthcare committees that Vermont’s hospital system is “in crisis,” and warned lawmakers that without rapid transformation Vermonters could face major service losses and steep insurance premium increases.

Holmes said analyses commissioned since 2019 — including work by Burns & HMA, Berkeley Research Group and Oliver Wyman under Act 167 — show the state’s 14 hospitals are financially fragile and that the system is paying for itself with unsustainably high prices. “We are in real trouble,” Holmes said. “If we do not get everybody around the table together to find significant cost savings and ways to ensure the preservation of essential services in all of our communities, patients are gonna suffer.”

The Green Mountain Care Board member said the board and its consultants estimated system transformation could save roughly $400 million over five years but that the state “doesn’t have five years.” Holmes urged finding $200 million in immediate, system-wide savings to limit projected premium increases that she said could reach 20–30% if federal subsidies and Medicaid funding are reduced or sunset. “If we cannot remove $200,000,000 out of the healthcare system in the very near term, we will be looking at these 20% or more rate increases,” she told lawmakers.

Why this matters: Holmes and other witnesses told legislators the combined effects of long-standing hospital losses, a shrinking commercially insured population, rising drug and workforce costs, and uncertain…