State agency outlines 'care transformation' effort, ties plans to recent laws and consultant report

Unidentified Chair convened the Senate Health & Welfare committee on Jan. 14 to hear an Agency of Human Services briefing on the state-led “care transformation” initiative. Sarah Rosenblum, interim director of Health Care Reform, and Katie Carroll, care transformation director, described how the work differs from the federal Rural Health Transformation grant and outlined statutory direction that frames the effort.

Rosenblum told the committee that affordability and access remain urgent concerns and said “more than half of our hospitals are operating at a loss,” a key reason state officials began pursuing transformation strategies. She traced the program’s legislative lineage to Act 167 (2022), which directed the Green Mountain Care Board to study hospital sustainability and led to an Oliver Wyman consultant report released in 2024. Act 51 (2023) then charged the Agency of Human Services to carry forward recommendations, and Act 68 (2025) reinforced AHS’s role and directed the agency to produce a statewide strategic delivery plan by 2028.

Carroll described the agency’s role as consultative rather than regulatory: the Green Mountain Care Board retains regulatory authority over hospital budgets, while AHS’s work focuses on affordability, access and helping hospitals transform care delivery. “We are providing…a more collaborative consultative relationship. It’s not a regulatory relationship,” Rosenblum said.

Staff emphasized that the 2028 strategic plan will be a dynamic, living document rather than a static roadmap. Carroll said the plan’s high-level goals — affordability, access and quality — will guide specific initiatives, including prevention, hospice utilization, mental health urgent care, mobile integrated health and advanced primary care management. AHS also plans to provide analytics and planning tools to ensure transformation work is data-driven and aligned with state population needs.

The briefing repeatedly stressed that transformation work is already underway in regions rather than waiting for the statewide plan. As Rosenblum put it during questions, “We are not waiting for 2028 to work on how we need to transform.” Staff said AHS will summarize hospital draft plans and later present consolidated regional and statewide insights to the committee.

Next steps: AHS will return with summaries of hospital draft plans and with updates on how regional planning will feed into the statewide strategy.