![\"Larner](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/09\/Larner-Medical-School-1200x801.jpg\")
Larner Medical School. Photo by Bob LoCicero\/VTDigger<\/p>\nLarner Medical School. Photo by Bob LoCicero\/VTDigger<\/p>\n
When Green Mountain Care Board chair Owen Foster first started to dig into Vermont\u2019s hospitals\u2019 budgets, one question kept surfacing: Where could all the money be going?\u00a0<\/p>\n
The solvency of the state\u2019s primary commercial insurer was teetering. Vermonters paid some of the highest rates for healthcare in the country. And still, hospitals\u2019 budgets were tight. How could there not be enough money?<\/p>\n
Part of the answer, Foster said, lies in the Larner College of Medicine and graduate medical education training at the University of Vermont Medical Center.\u00a0<\/p>\n
In a late July memo<\/a>, health policy analyst Nancy Kane, who is a professor at the Harvard T.H. Chan School of Public Health, determined that it cost UVM Medical Center $161 million to run its medical education programs<\/a> in 2025. Of that, $82 million came from commercial insurance payers, Kane found \u2014 as in, average Vermonters relying on the UVM Health network for care. She estimated that number would be on track to reach $88 million for 2026.\u00a0<\/p>\n Now, the care board is asking the medical center to provide more information so the state can better understand Larner\u2019s finances and how the college is serving Vermont\u2019s needs. The medical center is on board.<\/p>\n \u201cI personally see this as an opportunity to do a better job at sharing information with the board about what we\u2019re spending our money on,\u201d said Dr. Ramsey Herrington, who leads UVM Health\u2019s Medical Group. \u201cI think it\u2019s an opportunity for us to also think about what needs we\u2019re meeting in our educational program, and what other needs are out there for Vermonters.\u201d<\/p>\n The care board approved annual budgets for Vermont\u2019s 14 regulated hospitals earlier this month, and the directives for UVM Medical Center\u2019s budget<\/a> hinged on the medical center and its affiliated medical college improving their financial transparency.\u00a0<\/p>\n Vermonters who buy their health insurance through the state\u2019s Affordable Care Act marketplace pay some of the highest premiums<\/a> in the country. In recent years, the care board\u2019s budget orders have targeted what hospitals charge commercial insurers<\/a>\u00a0in an attempt to reign in healthcare spending.<\/p>\n Kane, the health policy analyst, determined that only a few senior leaders at UVM Medical Center, the medical school and the affiliated medical group understood and decided what money moved where. She called the whole process a \u201cblack box.\u201d<\/p>\n Now the care board wants to open that black box.\u00a0\u00a0<\/p>\n The Sept. 14 care board order requires the hospital to form a public working group alongside representatives from the medical school, the care board, the office of Vermont\u2019s Health Care Advocate, smaller rural hospitals, federally qualified health centers and other independent stakeholders.\u00a0<\/p>\n The group must examine the role, expenses and \u201cmeasureable benefits\u201d of both the Larner College of Medicine and the medical center\u2019s residency programs. They have until Dec. 15 to prepare a plan for how UVM Medical Center should financially support medical education.\u00a0<\/p>\n At that point, the care board has a month to vote on whether or not to approve the proposal.\u00a0<\/p>\n Foster said he will be looking for strategies the school can employ to fill gaps that Vermont hospitals have typically filled with expensive traveling nurses or temporary clinicians, called \u201clocums.\u201d\u00a0<\/p>\n