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.

Seven 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.

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 Brattleboro Retreat 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. It oversees hospitals and health insurers to help improve health care quality and moderate costs for Vermonters via the following mechanisms:

  • The GMCB regulates hospital budgets. Vermont’s hospitals have proposed historically low budgets with a five-year average growth rate of 3.6%, half of the previous ten years’ average of 7.3%.

  • 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 nearly $150 million 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 $50 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 (link).

Have questions?

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