In a surprise to no one who follows healthcare, costs are rising across the US this year.
In Vermont, the problem is especially bad, as health insurance premiums jumped 24% in 2024 and are expected to increase another 14% this year, KFF reported. For example, KFF’s data shows Vermont’s Affordable Care Act marketplace plans jumped from an average of $732 per month in 2022 to $948 in 2024. That’s compared to national marketplace plan averages of $428 per month in 2022 and $468 in 2024.
That’s why state Sen. Tanya Vyhovsky proposed a bill in January to institute salary caps for Vermont hospital executives and clinical leadership.
If passed, the bill would limit compensation for a hospital’s executive and clinical leadership to no more than 10x the salaries of the lowest-paid patient-facing employees. The bill would also require the ratio of frontline workers to administrative employees fall in line with national averages.
Online news site the Vermont Digger reported hospital CEOs in Vermont “make more than double” what CEOs in other industries earn in the state.
“Recognizing that we’re in a healthcare crisis, and recognizing that I live in a rural state, and recognizing that we can’t cut critical patient services, this seemed like an obvious path forward for cost savings,” Vyhovsky told Healthcare Brew.
Deb Snell, head of the Vermont Federation of Nurses and Health Professionals, a union of healthcare workers, said she knows the problem of expensive care will take more than this one initiative, but health executives should be concerned about reducing costs and patient debt.
‘When everyone else is suffering, when medical debt in our state is so high and people are struggling to buy groceries and pay their rent, having that cap would at least be a show of good faith that [hospital execs] understand and they’re willing to work with us,” Snell said.
The bill is unlikely to move forward this legislative session, Vyhovsky said, but will be alive until next year.
Pay breakdown
Back in 2011, two hospitals, Fletcher Allen in Burlington and Central Vermont Medical Center in Berlin, signed an affiliation agreement to create the UVM Health Network. Snell said this decision resulted in “a lot of executives” and “so much oversight.”
John Brumsted, former president and CEO of UVM Health Network, made $1,787,177 with $68,822 in bonuses in FY 2022, according to the health systems’ 990 forms (he retired before the year ended).
The data shows that his salary steadily increased from $1,486,203 with $237,916 in bonuses in FY 2021 to $2,098,354 with $66,714 in bonuses in FY 2022.
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Similarly, in FY 2021, Alfred Gobeille, former EVP of operations and COO at UVM, made $619,561 with $41,841 in bonuses. In FY 2022, that rose to $813,757 with $120,324 in bonuses and $894,856 with $126,268 in bonuses until his resignation in May 2023.
This means that over two years, Gobeille’s total compensation increased about 54%. Meanwhile, the minimum wage in Vermont is $14 an hour.
“Our question always was: What are you doing that you deserve that kind of raise? Because we never see you. We don’t even know what you look like,” Snell said.
When asked for comment, Annie Mackin, chief network media relations officer at the University of Vermont Health Network, said in an emailed statement that UVM Network is working on solutions that “require tough decisions.”
“As a leading provider of care in our region, we recognize the urgency of this moment and are taking action, beginning with a series of cuts and commitments aimed at improving sustainability and affordability for Vermonters,” she added.
Zooming out
The Green Mountain State isn’t the only one interested in capping salaries. Its New England neighbor, Massachusetts, saw a protest over the issue among residents and fellows at Mass General Brigham (MGB) in March after the health system—the biggest employer in the state—laid off 1,500 people, the Globe reported at the time.
The 50-person protest supported in-progress legislation to create salary caps. The Boston Globe reported the clinicians were demanding CEO salaries to be no more than 50x the wages of the lowest-paid workers.
In relation to a minimum-wage employee who works 40 hours a week, that would mean CEO compensation would top off at $1.4 million, according to the Globe.
MGB’s CEO, Anne Klibanski, made more than $6 million including bonuses in FY 2023, according to the most recent 990 available. That’s up from nearly $5.4 million total in FY 2022.
Alex Cerjanic, a CIR/SEIU member leader and neurology resident physician at Mass General Hospital and Brigham and Women’s Hospital, said physicians see “how the private equity mindset in healthcare diverts resources from our patients and the frontline workers who take care of patients.”
"That’s why we support capping excessive CEO pay in healthcare—because no executive should make millions while their frontline workers are laid off and patient care sees less and less resources,” Cerjanic said.