Vermont Hospitals 101
2025 Guide for Elected Officials

From VAHHS CEO Michael Del Trecco:

It is a privilege to represent Vermont’s nonprofit hospitals. Every day, thousands of devoted people in our state work hard to care for and improve the health of Vermonters. Hospitals also contribute to their communities in countless ways—as providers, employers, educators, and as guardians of public health and promoters of wellness.

I encourage every legislator to visit your local hospital, learn about its contributions and challenges, meet the leaders and clinicians. And please call on us at VAHHS any time. We stand ready to answer questions, tell the hospitals’ important stories and work with all of you to make sure our state’s top-ranked health care system stays strong and innovative.

Learn More About Vermont’s Hospitals

Vermont is the most rural state in the nation and there are many characteristics of Vermont’s hospital system that reflect our rural composition. As of 2022, Vermont had the fourth fewest hospitals in the nation and for many Vermonters, their local hospital is the only hospital in their community.

Eight of Vermont’s hospitals are designated as Critical Access, which means they have fewer than 25 beds and the federal government considers them essential to the rural communities they serve.

Only one of Vermont’s hospitals—University of Vermont Medical Center—is an academic medical center and children’s hospital, providing complex care to patients and training for health care providers. UVMMC has trained 32% of Vermont’s physicians, including 40% of Vermont’s primary care physicians.

Six of Vermont’s hospitals are designated by the State of Vermont to provide psychiatric inpatient care. Two of these hospitals are freestanding psychiatric hospitals—Brattleboro Retreat and Vermont Psychiatric Care Hospital (not shown on the map).

Click on a hospital's map location to learn more:

Did you know?

All of Vermont’s hospitals are nonprofit and we are only one of five states without a for-profit hospital presence.

Get to Know your Local Hospital

Fast Facts About Vermont’s Hospitals

  • 24/7/365 Access to Care

    Vermont's hospitals are open 24 hours a day, seven days a week, delivering care to patients regardless of ability to pay.

    Vermont hospitals will provide emergency care 240,000 times in a single year.

  • 100% Nonprofit System

    All of Vermont's hospitals are nonprofit. Vermont is one of only five states without a for-profit hospital presence. Vermont has the fourth fewest hospitals in the nation and for many Vermonters, their local hospital is the only hospital in their community.

  • Small, Rural Providers

    A majority of Vermont hospitals are designated as critical access, which means they have fewer than 25 beds and meet an average length of stay requirement of 96 hours or less. Critical Access Hospitals are essential service providers for rural areas. Vermont's critical access hospitals have the highest average patient census when compared to other states.

  • Training the Future Workforce

    Hospitals have talent pipeline programs and partnerships with higher education to provide Vermonters with a pathway to a career in health care. Our academic medical center, UVMMC, has trained almost one-third of all physicians in Vermont. Training health care providers locally is one of the strongest factors in keeping health care providers in state after graduation.

  • Emergency Preparedness

    Vermont hospitals must constantly prepare to care for those harmed in large-scale accidents, natural disasters, epidemics, and terrorist actions.

  • Financial Benefit to Vermont

    Hospitals contribute Vermont’s Medicaid program through the Vermont provider tax. Hospitals’ provider tax payments, together with the federal match money they produce, cover the cost of providing hospital-based Medicaid services while contributing an additional $95 million to Medicaid.

We collaborate to make
Vermont a healthier and stronger place.

Community Benefit Programs and Services

Our hospitals are a vital part of Vermont’s communities, continually investing in direct support for local organizations and initiatives. Hospitals spearhead downtown revitalization projects, coordinate summer meal plans, establish housing partnerships, address the social determinants of health—and much more. Hospitals are also getting more involved in their communities through collaboratives that advance health and wellness.

  • Groundworks Collaborative, Brattleboro Memorial Hospital, HCRS, and the BrattleboroRetreat have formed a partnership called Healthworks to improve outcomes for individuals with complex needs who are either homeless or at risk of becoming homelessness. Healthworks involves the innovative use of medical and mental health practitioners working outside of traditional office settings.

  • Copley Hospital is a partner in the Lamoille Health Collaborative, a partnership of 10 community-health organizations that share resources and expertise to advance population health and wellness.

  • Northwestern Medical Center is currently participating in the CAIRES Accountable Community for Health that brings together partners from health care, social services, and other sectors, as well as representation from the community, to take responsibility for the health of Grand Isle and Franklin Counties.

  • Northeastern Vermont Regional Hospital is a partner in NEK Prosper!—an accountable community for health that envisions a community where everyone is financially secure, mentally and physically healthy, well housed, and well nourished.

  • North Country Hospital is a partner in Vibrant ONE—another Northeast Kingdom accountable community for health that works collaboratively toward building on the strengths of the community; honoring voice and choice; and fostering health and wellness, dignity and respect.

  • Several hospitals partner with VeggieVanGo to distribute thousands of pounds of fruits and vegetables along with information about cooking and eating nourishing foods at sites open to the public across Vermont.


  • Rutland Regional Medical Center partners with several organizations and community programs throughout the county, including the Chamber & Economic Development of the Rutland Region, United Way of Rutland County, Project VISION, and Come Alive Outside.

Vermont’s Unique Regulatory Framework

THE GREEN MOUNTAIN CARE BOARD (GMCB)

The GMCB is the only regulatory board of its kind in the nation. Comprised of an independent, five-member Board whose members are appointed by the Governor, it oversees hospitals and health insurers to help improve access, affordability, and quality of health care Vermonters via the following mechanisms:

  • Vermont’s hospital budgets have been subject to state review since 1983. Since its creation in 2012, the GMCB regulates hospital budgets through approving commercial rate and net patient revenue increases. Each year, the Board issues hospital budget guidance, which sets the benchmarks, measures, and conditions hospitals must meet for budget approval.  

    GMCB budget guidance has allowed hospitals to grow at 3.5%-4.3%.  The Board can also approve budget increases greater than these targets on a case-by-case basis, which has occurred more recently due to inflationary pressures, increased acuity, and increased demand in the healthcare services resulting from the COVID-19 pandemic.

    The GMCB also has a similar budget review process for accountable care organizations (ACOs) and health insurers. More information can be found on their website.

  • All health care facilities, including hospitals, must get an approval called a Certificate of Need from the GMCB before building, renovating, or buying medical equipment to ensure that Vermont’s health care system does not expand too quickly or unnecessarily, driving up costs for all Vermonters.

  • This plan addresses access, quality, and cost containment by identifying and prioritizing the needs in health care services, programs and facilities, as well as the resources available to meet those needs.

OTHER VERMONT REGULATORY REQUIREMENTS

  • Hospital licensing provides standards for the construction, maintenance, and operation of hospitals to promote safe, clean, and adequate treatment.

  • Every other year, hospitals conduct a survey to determine their unique community health needs. Hospitals must post the results, along with strategic initiatives developed to address the identified needs, annual progress on the implementation of the initiatives, and opportunities for public participation.

  • Vermont’s hospital report cards provide a direct comparison between hospitals on measures of quality, patient safety, health care-associated infections, staffing and financial health.

  • Hospitals contribute to Vermont’s Medicaid program through the Vermont provider tax. Hospitals’ provider tax payments, together with the federal match money they produce, cover the cost of providing hospital-based Medicaid services while contributing an additional $95 million to Medicaid.

FEDERAL REGULATORY REQUIREMENTS

In addition to complying with state requirements, Vermont’s hospitals must also meet extensive federal regulations, quality standards and reporting overseen by a variety of federal agencies. Hospitals must comply with 629 discrete regulatory requirements across nine domains, including the Centers for Medicare and Medicaid Services, Office of Inspector General, Office of Civil Rights and the National Health IT Coordinator.

  • Health and safety standards that health care organizations must meet to be Medicare- and Medicaid-certified.

  • To be tax-exempt under IRS regulations, a hospital’s margin must be reinvested in its mission to provide high-quality care, not paid out to any private shareholders.

Want to learn more?

Check out the rest of our website for more information on VAHHS and our member hospitals. You can download a brief version of our hospitals 101 here:    https://www.vahhs.org/s/VAHHS-101-guide-2025.pdf

Have questions?

Reach out to Devon Green, Vice President of Government Relations at devon@vahhs.org.