Green Mountain Care Board – Montpelier, VT

Green Mountain Care Board

The Green Mountain Care Board (GMCB) is an independent regulatory body within the Vermont state government, tasked with a critical mission: to improve the health of Vermonters while controlling the rate of growth in health care costs. Created by the Vermont Legislature in 2011 through Act 48, the Board serves as a quasi-judicial entity that oversees the financial health and stability of the state’s medical system. Located on the 5th floor of 112 State Street, the Board operates transparently, ensuring that major financial decisions regarding hospitals and insurance plans are made with public input and rigorous analysis.

Regulatory Authority and Duties

The GMCB holds broad statutory powers to regulate the health care industry in Vermont. Its primary responsibilities include:

• Hospital Budget Review: The Board annually reviews and establishes the budgets for all of Vermont’s community hospitals. This process involves public hearings where hospital leadership presents their financial needs, and the Board determines if the proposed budgets align with the state’s cost-containment goals.
• Insurance Rate Review: To protect consumers from excessive premium hikes, the GMCB reviews rates proposed by health insurance carriers (such as Blue Cross Blue Shield of Vermont and MVP Health Care) for the individual and small group markets (Vermont Health Connect). They have the authority to approve, modify, or disapprove these rates based on actuarial analysis and public benefit.
• Certificate of Need (CON): Health care facilities must obtain a CON from the Board before making significant capital investments, such as purchasing expensive medical equipment or constructing new facilities. This prevents unnecessary duplication of services that could drive up costs.
• Accountable Care Organization (ACO) Oversight: The Board regulates the budget and certification of OneCare Vermont, the statewide ACO, under the Vermont All-Payer Model, which aims to shift payment from fee-for-service to value-based care.

Public Engagement and Transparency

Transparency is a core value of the GMCB. The Board holds regular public meetings, usually weekly, where they discuss ongoing regulatory work, receive staff recommendations, and vote on orders. These meetings are open to the public and are often broadcasted for remote viewing. The Board also solicits public comment on rate reviews and hospital budgets, providing a platform for Vermonters to voice their concerns about health care affordability.

Location and Access

The Board’s offices are situated in the Churubusco Building in the Montpelier Capitol Complex. Visitors attending hearings or meetings in person should expect security screening consistent with state government buildings. While many hearings are conducted virtually or in hybrid formats, the physical office serves as the administrative hub for the five-member Board and its professional staff of analysts, attorneys, and data experts.