UVM Health Network

UVM Health Network Adjusts to Improve Access to Care and the Patient Experience While Balancing the Budget

Efforts focus on supporting patients and staff while reducing expenses and creating new revenue sources


Burlington, Vt. – Responding to growing patient demand for care, a national workforce shortage, and persistent cost and budgetary pressures facing rural health care providers, The University of Vermont Health Network is focused on four strategic pillars to guide its work in the 2024 fiscal year, which began in October.

These areas of strategic focus include:  

  • Experience: Create an exceptional experience for patients, employees and others the health system serves.
  • Education and Research Mission: Advance health care through learning and innovation.
  • Stewardship: Improve the health of our communities and build public trust.
  • Operational Excellence: Attain a financial foundation that allows the health system to fulfill its mission.

Moving forward with momentum

Health system leadership is prioritizing an initial body of work building on the early success and momentum of initiatives that began last year. These efforts are attempting to strike a fine balance: Improving patient access while also maximizing revenue sources and reducing operating expenses, in order to invest in the talented and committed workforce, upgraded facilities and leading-edge equipment that patients in our service areas across Vermont and the North Country of New York deserve.

These efforts include:

  • Prioritize patient access to surgical services at UVM Medical Center, Champlain Valley Physicians Hospital and Central Vermont Medical Center – to both address long-standing patient wait times and generate a positive margin.
  • Launch self-scheduling in MyChart in FY24 so existing patients will be able to directly schedule appointments and services at times convenient for them.
  • Expand eConsult services across the system throughout the fiscal year. eConsults allow physicians to receive virtual patient consults from specialty care providers, often eliminating the need for a separate referral appointment and reducing the time it takes for patients to receive care.
  • In November, Alice Hyde Medical Center in Malone, New York successfully achieved federal Critical Access Hospital (CAH) designation, thanks to a tremendous internal effort and support from state and federal elected leaders. The new designation more appropriately captures the hospital’s essential role in our communities and the reimbursement model under CAH will support long-term sustainability.
  • Identify additional ways to reduce the amount of time patients stay in the hospital when it is more appropriate for them to be transferred to a different care setting.
  • Continued scrutiny of new hiring. While the hiring of patient-facing and clinical roles remains a priority, hiring into these positions is now evaluated more stringently.
  • Reduce $20 million in expenses for administrative services that support operations for all health care partners in the Network, including the elimination of 130 open positions.

By putting the above initiatives into place, health system leadership is attempting to avert a budget gap of more than $75 million in the current fiscal year, staving off the impact of persistent challenges including high inflation, national workforce shortages, a lack of post-hospital care options in the region and state regulatory orders to cut the FY24 operating budgets of the Network’s Vermont hospitals. The reductions in open positions will unfortunately reduce the ability to make progress on key patient-care and patient-experience initiatives, but are a necessary consequence of mandated budget cuts.

“Our health system plays a special role in our region, and it’s our responsibility to our patients, our employees and our communities to make sure we’re living true to our mission,” said Sunny Eappen, MD, MBA, President and CEO of the University of Vermont Health Network. “These guiding principles are how we hold ourselves accountable to the people we serve and address the operational and financial challenges we face. This body of work is our first step forward in this new direction and I’m excited for us to get to work.”

FY23 marked significant improvement, but persistent challenges require change

In shifting its strategic approach to respond to current and ongoing challenges, the health system’s strategic transformation is built upon several promising efforts put in motion last year. Combined, these efforts improved the FY 23 financial performance and included prioritizing access to select services with backups in access and maximizing cost savings across shared administrative services through the elimination of open positions, utilizing common digital systems that support patient care and implementing operational best practices across health care partner locations. 

For the fiscal year ending on September 30, 2023, the Network achieved a total margin of approximately $3 million, which was $47 million less than its budgeted margin for FY23. This follows several years of persistent financial losses and the compounding impact of the pandemic. Without pandemic relief funds, the Network would have lost $162 million in FY20, $54 million in FY21, and $145 million in FY22.

Improved patient and staff experience will be key priorities in FY24

Health system leaders, including Dr. Eappen, noted that the work in 2024 underscores the Network’s commitment to pursuing strategic priorities that respond to the needs of patients and staff.

“We have put some vital changes in motion over the past few years that support our ability to improve the experience for our patients and for our staff,” he said. “We are committed to pursuing equitable access to care, improving diversity, equity and inclusion within our organization and to working with our partners to address violence against our health care staff here and outside our walls.”

At the same time, Dr. Eappen noted it has become clear that achieving long-term financial sustainability requires a refocus in overall strategy, as historical approaches and methods have failed to keep up with the changing landscape of operating a rural academic health care system.

“We are taking a hard look at who we are and what we need to do to be a sustainable health care organization,” he said. “That is our commitment to our communities.”