Adapting to Meet Today's Health Care Challenges
Hospitals across the country — especially rural hospitals like ours — face unprecedented pressures. Nationwide shortages of health care workers, rising costs for labor and supplies and growing demand for services are colliding with declining reimbursements from insurers and reductions in Medicare and Medicaid funding.
As two of UVM Health’s seven health care organizations, 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 effectively and sustainably.
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, both invest these resources in our people, patients and facilities to provide high-quality 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.
| 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 closed fiscal year 2025 with a $4.3 million operating loss. While this is not where we wanted to be and does not reflect the tremendous effort by the entire team to manage expenses while providing great care, we are proud of the progress we’ve made in controlling costs while continuing to provide essential services for our community.
Learn More
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.
UVM Health Finances
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.
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.
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 | xxx | xxx | xxx |
| 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
- xx+ advanced practice nurses and physician assistants
- 85+ registered nurses
- 300+ 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 was extended through February 10, 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 Contract extension through March 13, 2026. Negotiations are ongoing. | 5/1/24 - 9/30/26 |
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.
Being a good steward of health care means caring deeply for the people who rely on us today, while making thoughtful choices that protect care for tomorrow. Across UVM Health, sustainability is about responsibility—to our patients, our workforce and our community. It means evolving how we deliver care, using resources wisely, and planning ahead so high-quality, compassionate care remains available close to home for generations to come.
Growing Our Own
Growing and sustaining a vibrant, skilled workforce starts with investing in our people at every stage of their careers. From students exploring health care for the first time to seasoned professionals advancing their expertise, we offer a comprehensive set of residencies, training programs and educational partnerships designed to support both personal growth and professional excellence.
Our residencies and training programs include:
- 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.