Adapting to Meet Today's Health Care Challenges
Hospitals across the country are facing unprecedented pressures. Nationwide shortages of health care workers, rising labor and supply costs and growing demand for services are colliding with declining insurer reimbursement and policy changes that are reducing Medicare and Medicaid funding, increasing uncompensated care and driving higher levels of bad debt. With additional changes to reimbursement, insurance coverage and federal health care policy anticipated, the challenges facing rural hospitals like ours are intensifying.
As part of UVM Health, Alice Hyde Medical Center and CVPH are responding to these challenges head-on. We are finding new ways to care for our community while supporting the skilled professionals who deliver that care. Through careful planning, operational improvements and thoughtful financial stewardship, we are improving efficiency, adopting new practices and making difficult decisions to ensure our hospitals continue to serve the North Country today and for generations to come.
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Our Future
Committed to Care. Committed to the Future.
Health care has always been a team effort — skilled professionals, community partners and neighbors working together to care for those who need it most. As the health care landscape continues to change, that collaboration becomes even more essential. In the North Country, our commitment remains the same: to ensure care stays accessible, compassionate and trusted for the people who rely on us. By focusing on the services we do best, strengthening partnerships and adapting thoughtfully to today’s challenges, we are working to ensure high-quality care remains here for our community today and for generations to come.
Health care is evolving — and we must evolve with it.
This is not about changing our mission but protecting it. By focusing on the services we do best, strengthening partnerships and adapting thoughtfully to the growing financial and operational pressures, our teams are working to ensure Alice Hyde and CVPH have the strong foundation needed to continue to provide high-quality care for our communities.
Our Finances
| Fiscal Year | |||||
| 2021 | 2022 | 2023 | 2024 | 2025 | |
| Operating Spending | $100,028,588 | $103,146,298 | $106,342,200 | $114,800,909 | $129,269,042 |
| Operating Income/Loss | ($2,297,842) | ($12,033,156) | ($11,308,370) | ($3,023,621) | ($4,225,536) |
| Days Cash on Hand | 102 | 67.9 | 17.1 | 27.4 | 24.4 |
| Fiscal Year | |||||
| 2021 | 2022 | 2023 | 2024 | 2025 | |
| Operating Spending | 373,607,663 | 420,319,588 | 456,517,604 | 460,677,441 | 513,965,760 |
| Operating Income/Loss | ($7,020,602) | ($30,441,115) | ($37,905,718) | ($1,984,520) | ($4,319,052) |
| Days Cash on Hand | 60.4 | 40.0 | 9.6 | 10.3 | 17.5 |
CVPH has been transparent about its financial challenges for many years. Through significant efforts across the organization — including reducing traveler costs, negotiating improved reimbursement rates with private insurers, optimizing services and leveraging cash reserves — the hospital improved from a $38 million operating loss in 2023 to a $4.3 million loss in fiscal year 2025. While meaningful progress, the hospital continues to operate at a loss, including approximately $1 million in losses during the first six months of FY26.
Next Steps
Since the arrival of COVID, CVPH has continued investing in its workforce and services, in part by liquidating virtually all cash reserves to support patient care and operations during an extended period of financial pressure. As those reserves are no longer available, ongoing investments must now align with reimbursement levels and the organization’s long-term sustainability.
At the same time, federal and state policy changes continue to reduce reimbursement, increase uncompensated care and bad debt and drive higher labor and supply costs. Additional anticipated changes to reimbursement, insurance coverage and federal health care policy are expected to create continued financial pressure for rural hospitals like ours.
While these challenges are significant, they do not reflect the tremendous effort of teams across the organization to manage expenses, improve operations and continue providing high-quality care and essential services for our community.
Learn More
Across Northern New York and Vermont, UVM Health and its partners are just beginning to feel the impact of the “Big Beautiful Bill” but expect that the substantial cuts to our Medicare and Medicaid funding will place added pressure on our budgets and operations.
At the same time, our Health System is taking steps to reduce costs and preserve access to care throughout the region. The FY26 budget approved by the Green Mountain Care Board, the regulatory body that oversees hospital and health system budgets, makes it clear that we must work differently as a system to reduce costs and increase efficiencies while continuing to provide quality care.
- The 2026 spending plan includes reductions in commercial insurance reimbursement and patient revenue and a cap on operating expenses in our Vermont partner hospitals.
- In July 2025, 77 positions were eliminated across the health system as part of a larger effort to cut more than $100 million in spending. That effort continued into the new fiscal year with the announcement of several senior executive positions being eliminated.
Next Steps
- The Green Mountain Care Board will finalize FY2027 Vermont hospital budget guidance in March 2026.
- UVM Medical Center can apply for a mid-year rate adjustment based on New York funds flow in July.
- FY2027 budgets are submitted and presented to the Green Mountain Care Board in July and August of 2026.
Our teams do an incredible job delivering exceptional care every day. As stewards of this organization, every employee plays a vital role in ensuring Alice Hyde and CVPH can continue serving the North Country. We all have a responsibility to make decisions that are financially sustainable — because wanting to do more and being able to do more are not the same in today’s rural health care environment.
Rural Hospitals Face Ongoing Financial Strain Despite New Federal Funding
The Big Beautiful Bill (H.R.1), which passed in July 2025, included both a $50 billion Rural Health Transformation Program to support rural hospitals and significant reductions in Medicare and Medicaid funding. While the new funding provides important relief, it offsets only a fraction of the overall shortfall, leaving rural hospitals under extraordinary financial pressure from inflation, staffing costs and reimbursement that does not reflect the true cost of care.
Where the Dollars Go
Running hospitals the size of Alice Hyde and CVPH is complex and costly — CVPH spends $1.5 million every day just to cover operating expenses, while Alice Hyde spends roughly $500,000 a day. As not-for-profit hospitals, those dollars keep our facilities running day to day, and any funds beyond those costs are reinvested in our people, facilities and equipment to help strengthen care for the communities we serve.
Here’s how expenses break down:
- Labor & Compensation (~64–69%)
Our doctors, nurses and staff who deliver care every day, plus their benefits. - Drugs & Supplies (~17–18%)
Medications, vaccines, surgical instruments and essential medical supplies. - Purchased Services (~3–5%)
Lab tests, imaging services, IT support and contracted services that help us operate efficiently. - Facilities & Utilities (~3–5%)
Maintaining safe, clean buildings, electricity, water, heating and repairs. - Operations & Support (~3–5%)
Patient records, billing, safety, security, compliance and everything that keeps the hospital running.
Our Patients
Alice Hyde Medical Center and CVPH share a long, proud history of caring for the North Country. Through decades of change, one commitment has remained constant: putting patients first while adapting to meet the evolving needs of our communities. Compassion, grounded in experience and guided by a willingness to grow, has been the cornerstone of our presence in the region for more than a century.
Each day, we unite heads, hands and hearts to provide high quality, compassionate care to our North Country friends and family — a responsibility we take great pride in and are committed to now and in the days ahead.
| Number of: | Fiscal Year | ||
| 2023 | 2024 | 2025 | |
| Admissions | 4,198 | 4,375 | 5,017 |
| ED Visits | 13,753 | 14,216 | 15,406 |
| Surgeries | 694 | 700 | 739 |
| Outpatient Visits | 720,119 | 769,355 | 810,084 |
| Number of: | Fiscal Year | ||
| 2023 | 2024 | 2025 | |
| Admissions | 55,890 | 52,370 | 54,571 |
| ED Visits | 38,023 | 39,751 | 40,726 |
| Surgeries | 7.308 | 6,989 | 6,971 |
| Births | 817 | 611 | 619 |
| Outpatient Visits | 2,068,624 | 2,128,004 | 2,307,035 |
Our People
North Country Strong
Rooted in North Country values, our teams go beyond caregiving. We are stewards of our hospitals, carrying out our work with compassion, humility and a deep understanding of the privilege it is to care for others.
Every day, we combine our skills, experience and knowledge to provide high-quality, compassionate care to our North Country friends and family. We support one another in challenging times, give back through community programs and volunteer efforts, and consistently show up for the people and communities we serve.
It’s our people that make the difference.
- 750+ employees
- 27 physicians on our medical staff
- 38 advanced practice nurses and physician assistants
- 85+ registered nurses
- 30+ volunteers
| Our Union Partners at Alice Hyde | ||
| NYNSA | SEIU | |
| Number of Employees Represented | 85 registered nurses | 280 members |
| Dates of Contract | 1/1/24 - 12/31/25 The contract has been extended through May 25, 2026. Negotiations are ongoing. | 7/1/25-6/30/28 |
- 2,400+ employees
- 125+ physicians on our medical staff
- 70+ advanced practice nurses and physician assistants
- 700+ registered nurses
- 300+ volunteers
Both New York Nurses Association (NYSNA) and Service Employees International Union (SEIU) 1199 have had presence at CVPH since 1990.
| Our Union Partners at CVPH | ||
| NYNSA | SEIU | |
| Number of Employees Represented | 913 members | 1,222 members |
| Dates of Contract | January 1, 2024 - December 31, 2025 A contract extension expired on May 12, 2026. Negotiations are ongoing. | 5/1/24 - 9/30/26 |
At Alice Hyde Medical Center and CVPH, our employees are proud stewards of their organizations, caring for the people who rely on us today and making thoughtful choices to ensure high-quality care for generations to come.
Growing Our Own
Building and sustaining a strong workforce starts with investing in people at every stage of their careers. From students exploring health care for the first time to experienced professionals advancing their skills, we are committed to creating local pathways to learn, grow and lead close to home. Through educational partnerships, training programs and career development opportunities, we’re helping to strengthen our workforce and the communities we serve.
Workforce Development & Career Advancement
- UVM Health Network Center for Workforce Development for Laboratory Technicians, OR First Assists and Respiratory Therapists
- Leadership development programs for new, emerging and nursing leaders
- Tuition assistance for employees pursuing continued education
- Philanthropy-supported education funding opportunities
Academic & Educational Partnerships
- Strong partnerships with North Country Community College and SUNY Canton to provide onsite educational opportunities for RN, LPN and Radiologic Technology
- Clinical rotations for physician residents from UVM Health Emergency Medicine, CVPH Family Medicine and Harvard Medical School
- Clinical and educational experiences for students in: Pharmacy, Occupational Therapy (OT), Physical Therapy (PT), Respiratory Therapy and Dietetics
Clinical rotations and hands-on learning opportunities
- Paramedic students from Elizabethtown Community Hospital and Clarkson University
- Basic and Advanced EMT students from regional programs, including Monroe Community College, North Country and E-Town programs
- Nurse Practitioner (NP) students in Primary Care, Pediatrics and Women’s Health
- SUNY Plattsburgh Leadership and Management students
- Partnerships with regional BOCES programs provide hospital shadowing and career exploration opportunities for high school students through New Visions, Health Occupations and HVAC programs
Tuition assistance and scholarships available through Alice Hyde Philanthropy as well as our Auxiliary Scholarship Program supporting students pursuing careers in medical fields and continuing education.
- Family Medicine Residency
- Pharmacy Residency
- New Nurse Residency
- School of Radiologic Technology
- CV Tec New Vision
- Nursing students from Clinton Community College, Plattsburgh State University and North Country Community College complete clinical rotations here.
- Career development program
Supporting this pipeline is a robust set of education and career advancement resources that help us retain talent and strengthen our connection to the communities we serve, including:
- Educational Career Advancement Program (ECAP). Offering tuition assistance in exchange for a work commitment after program completion.
- Workforce Development Pathways. Providing training and certification opportunities for both employees and community members pursuing health care careers.
- Foundation of CVPH Scholarships. Supporting current employees pursuing advanced degrees or certifications and local high school graduates entering health care fields.
- An ongoing partnership with SUNY Plattsburgh to deliver onsite educational opportunities
Big Picture Approach
President Michelle LeBeau and the senior leadership team share with Alice Hyde and CVPH employees organizational successes, opportunities and challenges. The Big Picture newsletter provides up-to-date information and data combined with the senior leaders’ perspective to support employee engagement in the important issues facing Alice Hyde and CVPH.