Green Mountain Care Board forces new transparency on UVM’s medical-education funding

Vermont's hospital regulator, the Green Mountain Care Board, pressed the University of Vermont Medical Center to explain how it funds medical education after finding substantial costs tied to training programs. A July memo by health policy analyst Nancy Kane estimated UVM Medical Center spent $161 million on medical education in 2025, with roughly $82 million covered by commercial insurance payers.

In its Sept. 14 budget order, the care board approved hospital budgets but attached conditions to UVM Medical Center's filing. The hospital must form a public working group with the Larner College of Medicine and a range of state and community stakeholders. The group's job is to examine the role, expenses and "measurable benefits" of both the medical school and the center's residency programs, then propose a plan for how the hospital should financially support medical education.

The working group has until Dec. 15 to deliver a plan. The care board then has one month to decide whether to approve it. If the board does not approve the group's proposal, the medical center will be subject to a set of reporting requirements meant to provide a similar level of accountability and transparency.

The care board's budget orders aim to reduce commercial healthcare spending and to make clear where patient dollars go. The Kane memo raised concern that only a handful of senior leaders understood the flows between the medical center, its medical school, and the affiliated medical group — what Kane described as a "black box." The board wants to open that box so the public can see how much commercial-payer revenue supports training and whether that spending advances Vermont's workforce and patient-care needs.

Issues the group is expected to address

The working group will evaluate whether medical-education spending helps fill clinical gaps across the state. Specific areas raised by UVM Health leaders include primary care, mental health care, and anesthesiology. The group will also look at where Vermont relies on locum tenens (temporary clinicians) and out-of-state providers and whether residency programs can be deployed strategically to reduce those costs.

Potential trade-offs and considerations

UVM leaders note that residents offer a relatively efficient source of clinical labor because the federal government partly funds their salaries and training. But any proposal the group produces must balance educational priorities with practical workforce outcomes for Vermont communities. The board will be looking for plans that clearly map spending to measurable benefits for patients and the state health system.