For many years, the Green Mountain Care Board (GMCB) conducted its annual expenditure analysis using a localized approach tailored to the Board’s specific needs. However, as Board members sought greater national benchmarking to compare Vermont’s healthcare spending with other states and regions, GMCB adopted a revised methodology. This approach aligns with standardized CMS National Health Expenditure definitions to define overall statewide “Personal Health Care” spending and its broad sectors.
This methodological shift led to a multi-year pause in reporting, with the last expenditure analysis released in Spring 2022, covering the year 2020. This report represents a key step in catching up, covering expenditures for 2021 and 2022, along with projected spending through 2024. Given current data sources, the time lag between the end of a calendar year and GMCB’s ability to complete expenditure reporting is approximately 15-18 months due to medical claims adjudication and analysis time. As a result, the 2023 spending report is scheduled for release this summer, and the 2024 report planned for Spring 2026, bringing reporting timelines as close to real-time as possible.
This report presents Vermont’s healthcare spending through two key lenses:
- Vermont Residents: Individuals whose primary residence is in Vermont, regardless of where they receive care. This includes “snowbirds” who temporarily relocate (e.g., to Florida) but still receive care while out of state. This population is primarily represented in Vermont Health Care Uniform Reporting and Evaluation System (VHCURES), which captures medical, dental, and pharmacy claims for services paid by Vermont-based insurers, regardless of the service location. Vermont’s All-Payer ACO Model Total Cost of Care is a subset of this spending.
- Vermont-Based Providers: Healthcare services, goods, and expenditures at Vermont-based providers, regardless of where the patient resides. This includes expenditures captured in regulatory decisions made by GMCB, such as hospital budget Net Patient Revenue growth.
The Expenditure Analysis reports provide insights into the following key questions for each lens:
- Total Spending: How much is spent statewide on “Personal Health Care”? How is spending distributed across different insurance types and broad sectors? (Reported as: aggregate spending in millions.) What is the yearly percentage growth in spending by insurance type and sector? (Reported as: percentage growth and Compound Annual Growth Rate (CAGR).)
- Sector Contributions & Trends: Which broad sectors contribute most to healthcare costs? How have these shares changed over time? (Reported as: sector spending as a percentage of total expenditures.)
- Per-Capita Spending (Vermont Residents Only): What is Vermont’s annual per-capita healthcare spending? How does spending vary by insurance type and sector? (Reported as: per-capita spending in dollars.)
This analysis aims to enhance transparency, inform policy decisions, and provide a standardized, data-driven approach to understanding healthcare expenditures in Vermont. For more information on methods and associated limitations: https://gmcboard.vermont.gov/document/expenditure-analysis-methodology
The 2021 and 2022 Expenditure Analysis reports mark a departure from previous methods. In partnership with Onpoint Health Data, the GMCB produced the following:
Vermont Expenditure Analysis (interactive report)
Historical expenditures analysis (data)
Projected expenditures 2023-2024 (data)
For questions, please reach out to GMCB.Data@vermont.gov.