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Hospital Sustainability and Act 167

The financial health and sustainability of Vermont’s hospitals has been top of mind for the GMCB for years. Given the national trends of rural hospital closures, the GMCB has been studying opportunities to ensure hospitals’ financial health.  

In 2022, the Vermont Legislature passed Act 167 which included funding for the GMCB to deepen its work on these issues in partnership with hospitals, other health care providers, insurers, Vermonters, and other State of Vermont partner agencies. The final report for the Community Engagement project can be found here.

Community Engagement to Support Hospital Transformation

Global Budget TAG

Hospital Sustainability Resources

Act 167 of 2022

While Act 167 focuses on hospitals and hospital-based services, hospitals are one part of the broader health care system, and each of these workstreams will seek broad input from communities about their experiences with Vermont’s health care system and recommendations for the future. 

Image shows the four workstreams of Act 167 of 2022 Sections 1 and 2. Section 1 has three workstreams: Subsequent All-Payer Model Agreement (AHS leads, GMCB Collab.); Developing Value-Based Payment Models, Hospital Global Budget Development (GMCB Lead, AHS Collab); Evolving GMCB Regulatory Processes, GMCB Hospital Budget Review Process (GMCB). Section 2 has one workstream: Community Engagement to Support Hospital Transformation (GMCB Lead, AHS Collab.).

For more information about each of these workstreams, including updates and how to get involved, please click on the links below.

Subsequent APM Agreement: In December 2022, a short-term extension of the current APM agreement was signed by the Governor, Secretary of AHS, and Chair of GMCB, providing a bridge to a potential future federal-state model. AHS is leading Vermont’s collaboration with the federal Center for Medicare and Medicaid Innovation (CMMI) to inform future federal-state models, informed by the members of the Health Care Reform Work Group. 

Developing Value-Based Payment Models – Hospital Global Budget Development: In January 2023, GMCB and AHS co-convened a Hospital Global Budget Technical Advisory Group which is expected to run through the end of 2023.

Evolving GMCB Regulatory Processes – Hospital Budget Review Process: The GMCB is undertaking a dedicated scope of work to review and update its regulation of hospital budgets. 

Community Engagement to Support Hospital Transformation: This work includes facilitating community meetings to gain a deeper understanding of the current state of Vermont’s health care system, including the experiences of Vermonters and their health care providers, and to support hospitals in identifying short, medium, and long-term actions to keep them financially sustainable while providing high-quality care to their communities.