UVM Medical Center, Burlington, Vermont. Courtesy photo.

Staff Reductions, Further Unification of Health System, Part of Targeted Ongoing Affordability Work

Vermont Business Magazine As part of the ongoing regional effort to make health care more affordable for patients and communities, University of Vermont Health Network today announced new steps to reduce expenses. The plan includes reducing the administrative and non-direct patient care workforce, operating more efficiently in areas like budgeting and staffing, and improving care coordination. Additionally, after discussion with the senior leadership team, UVM Health Network’s Board of Trustees has also approved a pause on performance-based variable pay for all leaders this fiscal year ending in September. This is part of their effort to reduce expenses by over $185 million.

Administrative staffing cuts

To continue reducing expenses, the health system has made the difficult decision to eliminate a number of positions that are almost entirely administrative and non-direct patient care roles supporting health care partners across UVM Health Network. Examples of these types of roles include areas like finance, human resources, project management and continuing education support.

As part of the latest actions, a total of 146 largely administrative and non-direct patient care positions have been eliminated across the health system. Of those, 77 were filled roles (68 staff level and 9 leader level), resulting in layoffs. This builds on earlier actions the health system took throughout the year to gradually cut several hundred of primarily non-direct patient care roles, either vacant or in active recruitment. UVMHN employs 4,000 health care professionals across its system, which is led by the UVM Medical Center in Burlington.

Positions were identified through a thoughtful and inclusive process, with input from each health care partner, as well as clinical, operational and administrative leaders, and guided by a commitment to reduce expenses while limiting as much as possible the impact on direct patient care. The health system is offering transition support, including opportunities to pursue other available roles, for employees impacted by the latest actions.

Expense Reduction Actions

Capital planning – Reductions in capital budget for FY26, prioritizing projects with greatest need and long-term impact: $70M

Efficiencies in clinical care – Revising clinical programs to increase access and quality while reducing cost through strategic medical device choices, reducing unnecessary testing, minimizing inpatient & ED stays, keeping care local: Up to $60M

Workforce management – Reducing travelers and locums, shared temporary worker hiring pool reducing duplication, replacing with permanent staff: $30M

Administrative cost reductions – New staffing cuts detailed on previous slide: Over $5 million

Additional administrative efficiencies – About $10M

Eliminating leader variable pay for FY25 – $7-10M

Real estate optimization – Consolidating physical spaces: about $400,000 per year

“Today is a difficult day for our organization. We need to take these steps now because health care is changing, but these decisions have a personal impact on the employees who were affected and their families who are looking at what comes next,” said Sunny Eappen, MD, MBA, president and chief executive officer of UVM Health Network. “I’m sorry for the disruption and uncertainty these actions create for our colleagues who are impacted. I want to thank them for their dedication to our patients and for their work in supporting our health system.”

Sunny Eappen, MD, MBA, president and CEO of UVM Health Network. VermontBiz photo.

Dr. Eappen added: “The people of this organization have served Vermont and northern New York for more than 100 years, and it’s our responsibility to ensure access to affordable, high-quality care in our region, now and into the future. That’s why everything we do must be in service to our patients and communities – even when we’re making incredibly difficult decisions. Whether I’m rounding in our hospitals and clinics, or talking with neighbors at the grocery store, I hear clearly that health care is too expensive. To address affordability head on, UVM Health Network is examining our role and taking action to reduce our costs to deliver care. So far, we’ve done so by increasing efficiency, cutting purchasing costs, delaying investing in infrastructure, and other important steps. But the truth is, to meet this moment, we must make one of the most difficult decisions of all: We have to reduce our staffing. Today, we’re announcing a reduction largely in our administrative workforce. This is difficult news to share and in no way a reflection of the work of our colleagues, but a reality of the changing landscape of health care. I want to honor the contributions of these people, who are our friends, neighbors and family – they have done important work to support the care we provide.”

While the organization is making necessary reductions in certain areas, UVM Health Network will continue to make strategic investments in other critical areas that support our ability to provide timely access to high-quality, equitable and efficient care, and will work with impacted employees to find suitable open roles in those areas where possible.

Improving efficiency as a unified health system is a primary focus

As a system made up of individual organizations that joined together organically over the past decade and a half, UVM Health Network has additional efficiencies and savings to realize by becoming a unified, high-performing system with benefits that are easy to see and feel for patients. The health system is accelerating more of this multi-year work, including: Working as one to reduce purchasing costs, further cut already reduced spending on temporary workers like nurse travelers and efficiently match staffing to real-time need throughout the region. Additionally, vendor contracts and real estate will be re-evaluated to find savings. Operations will be more effective with streamlined approvals, documentation and more.

“Health care is changing and doing things the way we always have is not sustainable, which means we must take meaningful action to make care more affordable, more accessible and at the highest quality,” Eappen added. “Today’s actions are an important step toward our affordability goals, but we have more work to do. To get there, we’re taking a hard look now and in the future at the costs we can control and focus on being more efficient to reduce the cost burden on patients, while continuing to support our dedicated workforce.

As part of the system’s efforts toward greater efficiency, leaders are working to identify how to maintain and strengthen patient experience with less administrative costs.

Next Steps and State, National Concerns

Vermont and northern New York face serious impacts from the recently passed and signed “One Big Beautiful Bill,” which includes nearly $1 trillion in cuts to Medicaid, and which will lead to an estimated 45,000 Vermonters and 1.5 million New Yorkers losing their health care coverage over the next 10 years.

While it will take some time to analyze and fully understand the impact of the law on the region’s patients, families and communities, it will negatively impact people’s health and put pressure on an already struggling health care delivery system nationwide. UVM Health Network will continue to assess the impact of these changes, but today’s actions are still at the beginning of the system’s efforts to reduce costs. The organization will need to take further actions to be more effective and efficient in the future. The health system is actively working with a team made up of representatives from the organization, the Green Mountain Care Board and an independent liaison to identify additional areas for improvement and value.

In this work, the health system is committed to being transparent, staying focused on putting patients and their health first, and continuing to make choices that help the organization effectively and efficiently support them for years to come.

About University of Vermont Health Network

University of Vermont Health Network is an integrated system serving the residents of Vermont and northern New York with a shared mission: working together, we improve people’s lives.

The partners are:

Source: 7.29.2025. Burlington, Vt. –UVMHN. https://www.uvmhealth.org/

Vermont’s largest hospital system announced dozens of layoffs this week as part of a plan to cut nearly $185 million in spending by the end of next year. It’s an effort to rein in ballooning health care costs in the state, which are among the highest in the country.

“We’re committed to examining our role and taking action to reduce expenses that influence health care costs,” Dr. Sunny Eappen, the CEO of the University of Vermont Health Network, said in a press briefing Tuesday.

Hospitals in the state account for nearly half of the state’s total spending on health care, and UVM Medical Center in Burlington, part of the health network, is by far the largest hospital. It’s responsible for more than half of all hospital revenue and is one of the largest employers in the state.

Vermont Public Dr. Sunil “Sunny” Eappen, the president and CEO of the University of Vermont Health Network, speaks during an episode of Vermont Edition on July 15.

The health system said it will layoff 77 non-clinical positions across the organization, including in finance, patient registration, human resources and information technology departments over the next few months. The organization also announced it will not fill dozens of vacant positions, in total expected to save more than $5 million.

Some layoffs are effective immediately, while other employees will stay on until September, according to a hospital spokesperson. The health system is offering impacted employees transition support, including opportunities to pursue other available roles.

More from Vermont Public: Vermont’s largest hospital says it’ll cut insurance rates by 8%

Earlier this month, the board of UVM Health Network also announced it would not give bonuses to any executives this year, expected to save up to $10 million. That came after UVM Medical Center and Central Vermont Medical Center in Berlin announced they would cut commercial insurance rates by 8% and 3%, respectively to comply with budget orders from state regulators.

After budget orders last year, the health network announced a range of cuts to patient services, including the closure of the in-patient psych unit at Central Vermont Medical Center and primary care clinics in Waitsfield. This year, the hospital has not proposed any further cuts to patient services.

In addition to layoffs, the health system will reduce its capital budget for next year by $70 million by delaying work on infrastructure that needs maintenance and pausing new construction projects. That includes waiting on planned renovations in the emergency department at Porter Medical Center in Middlebury and a garage expansion at UVM Medical Center in Burlington, according to Eappen.

More from Vermont Edition: UVM Health Network CEO Sunny Eappen on hospital spending

The hospital also announced a number of initiatives to improve clinical efficiency. That includes reducing the length of stay in the hospital and emergency department for certain conditions. Hospital leaders said they plan to reduce unnecessary testing and imaging, and want to standardize medications and medical devices used across the health system.

“We’re going to change the way we work,” Eappen said. “We’ve been pushed to do that, because we don’t really have another choice.”

The University of Vermont Health Network announced on Tuesday that they are making millions of dollars in cuts, including dozens of layoffs.UVM officials said 77 people were given notice that they were being laid off as the health network faces an affordability crisis. Hospital officials said those job cuts were unavoidable.Nine of the terminations were for leadership roles, while an additional 68 were staff roles. Another 69 vacant positions were also eliminated. The network said it is focused on reducing non-clinical expenses, meaning the reductions are almost entirely part of its shared services team and will not directly impact patient care.The job cuts are expected to save the UVM Health Network up to five million. Combined with the other cuts made on Tuesday, the network stands to save an estimated $180 million.These are in addition to the $150 million saved earlier this year through other reductions, for a total of more than $330 million.Sunny Eappen, the CEO of the UVM Health Network, said he doesn’t take the cuts lightly.”Every one of the decisions that we make represents a person, and often whole families, who are now trying to figure out what comes next,” Eappen said. “I think it’s really important to make sure that you hear that this isn’t a reflection of their work, but are the changes happening in health care that are demanding us to take this kind of action.”Officials said they hope they won’t need to make additional job cuts, but they aren’t certain what the future will hold.

The University of Vermont Health Network announced on Tuesday that they are making millions of dollars in cuts, including dozens of layoffs.

UVM officials said 77 people were given notice that they were being laid off as the health network faces an affordability crisis. Hospital officials said those job cuts were unavoidable.

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Nine of the terminations were for leadership roles, while an additional 68 were staff roles. Another 69 vacant positions were also eliminated. The network said it is focused on reducing non-clinical expenses, meaning the reductions are almost entirely part of its shared services team and will not directly impact patient care.

The job cuts are expected to save the UVM Health Network up to five million. Combined with the other cuts made on Tuesday, the network stands to save an estimated $180 million.

These are in addition to the $150 million saved earlier this year through other reductions, for a total of more than $330 million.

Sunny Eappen, the CEO of the UVM Health Network, said he doesn’t take the cuts lightly.

“Every one of the decisions that we make represents a person, and often whole families, who are now trying to figure out what comes next,” Eappen said. “I think it’s really important to make sure that you hear that this isn’t a reflection of their work, but are the changes happening in health care that are demanding us to take this kind of action.”

Officials said they hope they won’t need to make additional job cuts, but they aren’t certain what the future will hold.

Sunny Eappen, president and CEO of the University of Vermont Health Network, speaks during a groundbreaking ceremony to announce a second investment in new housing in South Burlington on Dec. 15, 2022. File photo by Glenn Russell/VTDigger

Updated at 6:32 p.m.

The University of Vermont Health Network announced Tuesday it will cut 77 positions, including 68 staff roles and nine leadership roles, as part of its plan to reduce expenses for the coming fiscal year.

While some staff will remain in their roles until the end of the fiscal year in late September, other staff positions will end as soon as Tuesday this week, said Annie Mackin, the network’s spokesperson.

The health network — which comprises three hospitals in Vermont and three in northern New York — will also not fill 69 current vacancies following Tuesday’s announcement. The network chose not to fill 120 vacant positions last year, and several hundred more positions were phased out earlier this year.

The announced staffing cuts, which amount to over $5 million in spending reductions, come a week ahead of hospital budget review hearings overseen by the Green Mountain Care Board. The state regulating body is tasked with approving the amount of patient-related income in budgets for the next fiscal year at all 14 of the state’s non-federal hospitals.

The cuts are largely to positions not involved in direct patient care, specifically in the networkwide finance, human resources and information technology teams, said Mary Broadworth, vice president of human resources for the health network. The Vermont hospitals in the health network are Central Vermont Medical Center in Berlin, Porter Medical Center in Middlebury and University of Vermont Medical Center in the Burlington area.

Along with layoffs, the health network aims to reduce spending through deferring capital projects, increasing efficiencies in clinical care and administrative work, reducing the number of traveling and temporary workers in favor of permanent staff, eliminating tentative, performance-based bonuses for administrative leaders, and consolidating real estate.

The plans set forth Tuesday represent approximately $185 million in expense reductions, according to the network. The cost-saving measures will help the University of Vermont Medical Center meet its proposed $2.3 billion budget for the next fiscal year.

University of Vermont Health Network is requesting the Green Mountain Care Board approve a nearly 8% decrease in rates charged to commercial insurers by the Burlington hospital, the largest by far in the network, according to their budget review filings.

In recent years, the network has surpassed the Green Mountain Care Board regulated budget caps for patient revenue by millions of dollars. The regulatory board approved a settlement with the network this spring to address some of the overrages.

Staffing is the organization’s largest expense, with the non-physician workforce compensation accounting for 36 cents of every dollar spent by the network. In their effort to reduce costs, staffing cuts were “unavoidable,” Broadworth said.

The health network aims to support the staff impacted by the cuts, including identifying other opportunities within the organization, and minimize the “impact on patient care as a result of this decision,” Broadworth said.

Sunny Eappen, president and CEO of the University of Vermont Health Network, said the administrative layoffs and other cost-saving measures reflect the broader affordability challenges facing the health care industry in rural areas.

“Our goal has been to be very transparent and stay focused on putting patients and communities and their health first, and keep making choices that make us be effective and efficient to support them in the long term,” Eappen said.

Sunny Eappen, president and CEO of the University of Vermont Health Network, speaks at an event in 2022. File photo by Glenn Russell/VTDigger

Updated at 6:54 p.m.

The University of Vermont Health Network has reached a tentative agreement with the Green Mountain Care Board to resolve a dispute over the fact that the hospital network brought in roughly $80 million more patient revenue in the 2023 fiscal year than it was allowed to.

Under a proposed settlement announced Tuesday, the network would pay $11 million to “non-hospital” primary care providers and $12 million to the insurer Blue Cross Blue Shield. It would also fund a team of consultants and an “independent liaison” to review the network’s finances and operations.

The settlement also includes restrictions on bonuses paid out to hospital executives. In the 2026 fiscal year, at least half of executives’ bonuses would be tied to specific factors: reducing the usage of emergency departments, payments from New York hospitals to Vermont hospitals, and reducing prices charged to commercial health insurers and revenue from those insurers.

In return, the care board would loosen its restrictions on UVM Medical Center’s 2026 fiscal year budget. Initially, the board ordered the hospital to reduce its revenue from patients in the 2026 fiscal year by about $40 million to repay its 2023 fiscal year budget excess.

Under the proposed settlement, that $40 million would instead be spread evenly across the 2026 and 2027 fiscal years. And the regulator would forgo taking action to address a separate instance in which network hospitals exceeded their budgets, in the 2024 fiscal year.

The agreement would, hopefully, “change course for our health system,” Sunny Eappen, the president and CEO of the network, said at a Wednesday meeting of the Green Mountain Care Board. “It’ll change course for our working relationship with the Green Mountain Care Board, and most importantly, it’ll make care more affordable for Vermonters.”

The settlement represents a thaw in the sometimes frosty relationship between a powerful state health care regulator and Vermont’s largest hospital network.

Owen Foster, the chair of the Green Mountain Care Board, said at Wednesday’s meeting that he and other board members had spent months discussing the terms of the agreement with the hospital network’s leadership.

“There were some really candid and honest discussions, some very hard discussions,” Foster said. “I found it difficult at times, but also really critical that we all roll up our sleeves on behalf of the state.”

The agreement appears to be something of a conciliatory gesture from the network, which has drawn a firestorm of criticism in past months over cuts to services across the state, the movement of money from Vermont to New York hospitals, and the payouts of several million dollars in bonuses to executives.

In an interview Wednesday, Eappen apologized to patients about the way the network announced and implemented its service cuts last year.

“What we heard from our community members when we dropped these services is that, ‘Hey, how can you possibly do that? We rely on you,’” he said. “And so I think there is a loss of trust, and we’re trying to build that back up and acknowledging that, hey, we could have done this better, and we’re sorry about that.”

But that trust was sometimes elusive at Wednesday’s meeting. Several members of the public used the forum to express frustration about the high cost of health care in Vermont — and the network’s role in those high costs.

“I think the trust will start to grow when the premium rates go down,” said Alex LeClair, an employee at a physical therapy practice.

Others questioned the confidential negotiations that had led to the settlement — and the terms it contained. Why, some asked, would the payments included in the settlement not simply be used to buy down insurance rates for Vermonters?

“If I had an ability to influence what’s before you today, I would attempt to move towards more immediate rate relief for Vermonters,” Mike Fisher, Vermont’s chief health care advocate, said at the meeting.

A spokesperson for Blue Cross Blue shield declined to comment Wednesday.

The agreement must still be approved by the hospital network’s board of trustees and the Green Mountain Care Board, which has scheduled a vote for April 2. Members of the public are able to submit comments to the board until then.

Correction: A previous version of this story incorrectly described a provision of the settlement agreement.