![\"a](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/05\/mike-smith-2-20230524-1200x799.jpg\")
Mike Smith at the Vermont Technical College campus in Williston on May 24, 2023. File photo by Glenn Russell\/VTDigger<\/p>\nMike Smith at the Vermont Technical College campus in Williston on May 24, 2023. File photo by Glenn Russell\/VTDigger<\/p>\n
University of Vermont Health needs to cut its expenses by $300 million over the next three years and help clinicians in the 1,000-doctor outpatient Medical Group see more patients, said an independent liaison in a May 1 report<\/a> to the hospital network and the Green Mountain Care Board.\u00a0<\/p>\n The report specifically set out to address productivity problems in UVM Health\u2019s outpatient clinics and to project the five-year financial future of the health network.<\/p>\n UVM Health leaders said they are on board with these changes, even while recognizing the formidable challenges of taking them on.<\/p>\n \u201cAt the highest level, we support the key findings of the report,\u201d UVM Health President and CEO Steve Leffler said in an interview. \u201cIt\u2019s good for the patients that we serve and will help with access and affordability.\u201d<\/p>\n The hospital network\u2019s agreement with the liaison team\u2019s recommendations is a marked shift from past disagreements<\/a>. Leffler took over as the hospital network\u2019s new CEO and president of the network in October and has merged the role with his previous one as the president of UVM Medical Center.\u00a0<\/p>\n The report is the fourth such memo from the three-person liaison team, mandated by an agreement<\/a> between the UVM Health network and the Green Mountain Care Board, after the hospital network exceeded the budgets set by the care board in fiscal years 2023 and 2024.\u00a0<\/p>\n The liaison team, helmed by Mike Smith, has worked since spring 2025 to oversee the network\u2019s 2025 budget proposal, contract negotiations with BlueCross BlueShield of Vermont and other ongoing work surrounding affordability, access and quality of care. Though the liaison team does not have regulatory authority or the power to compel the hospital to act, its memos hold sway with the hospital group\u2019s board and the public.<\/p>\n READ MORE<\/p>\n \t\t\t\t\t\t\t\t \t\t\t\t\t\t\tby Greta Solsaa<\/a> Smith, the former commissioner of the Vermont Agency of Human Services, said in an interview he was heartened by how much UVM Health has embraced the team\u2019s recommendations.<\/p>\n \u201cI have been fairly critical of the leadership in the past. I will say this leadership has done a 180 and is really looking at how they can improve,\u201d Smith said.<\/p>\n Outpatient efficiency\u00a0<\/p>\n One part of the memo addresses long appointment wait times and lagging productivity in what\u2019s known as the Medical Group, a group of 154 outpatient clinics and 1,000 physicians in the UVM Health network. This group operated at a $279.9 million deficit last fiscal year, the consultants found, which they said was offset by the hospital network charging higher prices in other areas.\u00a0<\/p>\n The network could shrink that loss by $55 million, the report claims, with changes to how the Medical Group schedules physicians\u2019 time.\u00a0<\/p>\n Leffler said in an interview that the hospital knows it needs to improve in this area, and the consultants have given a sharper resolution to where the clinic group can be more efficient.<\/p>\n The consultants found high rates of doctor-driven cancellations and schedules that don\u2019t maximize doctors\u2019 time. They described \u201clabor-intensive\u201d and outdated scheduling processes that could be improved by more modern technology.<\/p>\n The result, they wrote, besides high cost, are long wait times lagging far behind the 50th percentile of benchmarks at peer organizations.\u00a0\u00a0<\/p>\n The report notes that on average, patients at UVM Medical Center wait 96 days for an appointment; for a new patient with a referral, that can be 104 days. A report<\/a> from the American Academy of Family Physicians found that in 2025 on average patients across the country waited 23 days for a family medicine appointment, though it varied by region \u2014\u00a0in Boston, patients waited an average of 69 days to see a family medicine doctor.<\/p>\n The liaison team recommended that clinicians dedicate more time to patient-facing hours and that the clinics could better align their appointments with the skills and relative cost of the right type of provider.\u00a0Nurse practitioners or physician assistants, for instance, could see patients when appropriate.<\/p>\n \u201cPhysicians will have to give up some autonomy over their work hours, see more patients, possibly reduce their administrative commitments, and reduce their flexibility to make last minute scheduling changes,\u201d the authors wrote.<\/p>\n Already, two clinics \u2014\u00a0orthopedics and psychiatry \u2014\u00a0in the UVM Health network are beginning to figure out how to incorporate better scheduling into their practices, according to Leffler.<\/p>\n \u201cThere\u2019s a balance, right?\u201d Leffler said in the interview. \u201cWe need our clinicians to take care of as many people as we can, but they\u2019re a finite resource.\u201d\u00a0<\/p>\n \u201cOur plans are not to have them not be able to have lunch or a breath of fresh air,\u201d he added.\u00a0<\/p>\n The network\u2019s job will be to make everything surrounding the practice of medicine \u2014\u00a0the non-human, paperwork parts \u2014\u00a0easier for the doctor, Leffler said. He hopes that improvement is what makes their schedules more efficient.\u00a0<\/p>\n $300 million in expenses<\/p>\n The liaison team also built a financial model for what the hospital network can expect in the next five fiscal years.\u00a0<\/p>\n The authors expected reductions in revenue from Medicaid changes that begin in 2027<\/a> and from commercial insurers (such as BlueCross BlueShield of Vermont), as pressure to keep the plans\u2019 premiums low is likely to also keep their payment rates low. Other revenue sources \u2014\u00a0Medicare and other direct payments \u2014\u00a0are expected to remain about the same. And a federal drug program<\/a> that allows hospitals to buy steeply discounted drugs, and some changes to retail drug purchasing, should yield some savings.<\/p>\n The report\u2019s authors predict that this \u201cstagnant\u201d revenue with rising costs will yield significant financial losses to the network if it does not cut some expenses.\u00a0The most likely scenario projects about a $414 million operating deficit for fiscal year 2030.\u00a0<\/p>\n The authors recommended the network reduce its expenses by at least $300 million over the next three years, phasing changes in by $100 million each year to try to mediate the inevitable disruption this could bring to the system.<\/p>\n \u201cThat\u2019s a big number,\u201d Leffler said. \u201cIt\u2019s hard to imagine how we\u2019re going to do that, but we have to do it one step at a time.\u201d<\/p>\n
\n\t\t\t\t\t\t\t\t\t\t\t\t![\"Discord](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/01\/Leffler-Eappen-composite-1200x900.png\")
\t\t\t\t\t\t\t\t\t\t\t\t<\/a><\/p>\n
\n\t\t\t\t\t\tAugust 13, 2025, 5:14 pmAugust 13, 2025, 5:14 pm\t\t\t\t<\/p>\n![\"A](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/05\/stephen-leffler-1-20251031-1200x798.jpg\")
Dr. Stephen Leffler speaks during a press conference at Central Vermont Medical Center in Berlin on Friday, October 31, 2025. File photo by Glenn Russell\/VTDigger<\/p>\n
![\"A](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2025\/10\/uvmmc-3-202011123-1200x801.jpg\")
The University of Vermont Medical Center in Burlington in November 2020. File photo by Glenn Russell\/VTDigger<\/p>\n