Steve Leffler, MD, began serving as interim CEO of Burlington-based University of Vermont Health in October, when Sunny Eappen, MD, stepped down. Coming into the role, Dr. Leffler recognized the need for financial trade-offs.
“In our rural region, as across the country, people are struggling with the cost of healthcare,” Dr. Leffler told Becker’s. “UVM Health has committed to evolving as a health system to better meet the growing needs of our patients, while operating more cost effectively. We need to cut expenses, but improve quality and access at the same time.”
With that in mind, UVM Health, a rural academic health system with about 15,000 employees, has committed in 2026 not to cut any clinical services, despite significant financial pressures.
“To do that, everything’s a balance. If you’re going to have your expenses come down, without cutting clinical services, there has to be give on the support structures or the other functions that support that,” said Dr. Leffler, who is also president and COO of the health system’s University of Vermont Medical Center.
As part of this balance, the health system will spend less capital in 2026, though the organization has huge demands for capital, Dr. Leffler said. UVM Health includes UVM Medical Center in Burlington, Central Vermont Medical Center in Berlin, and Porter Medical Center in Middlebury, Vt., as well as multiple hospitals in New York and a home health and hospice care provider.
UVM Health has also made administrative cuts as part of an organizational restructuring, including eliminating some leadership roles. By the end of 2025, the health system will phase out its COO, chief medical officer and chief of staff positions. Mark Gordon, Danielle Mahaffey, MD, and Brittany Sheehy serve in those roles, respectively. Jason Williams, health system chief external relations officer, is also resigning as part of the transition.
The objective of the transition is to create “a more efficient system of leadership and governance structure that is more closely connected to the communities we serve and better aligned with the system’s anchor academic medical center,” the health system said in a previous statement shared with Becker’s. The C-suite layoffs follow the elimination of 146 vacant and full-time roles at the health system in July and a pause in performance-based pay for leaders for fiscal 2025.
Dr. Leffler said UVM Health is also continuing to look at non-patient-facing expenses “to see where we can continue to be more efficient and effective.” Additionally, he said the system is improving efficiency in terms of care delivery by reducing duplication, streamlining workflows and investing in technology — including AI — that helps clinicians spend more time with patients and less time on paperwork.
“We’ve committed to being transparent with our teams, our state and federal partners, and our communities, and are sharing information and the reasoning behind our decision-making as early and often as we can,” Dr. Leffler said. “Figuring out this balance of improving quality and access while reducing expenses is a tall order, but I believe our health system is up to the challenge, because we have to be.”
