The University of Vermont Medical Center in Burlington on Thursday, June 6, 2019. File photo by Glenn Russell/VTDiggerFor the second year in a row, University of Vermont Health Network hospitals reported bringing in more money than they were supposed to.During hospitals’ 2024 fiscal year, which ended September 30, the University of Vermont Medical Center and Central Vermont Medical Center recorded a combined total of about $2.2 billion in patient revenue, according to figures provided by the network.That figure is $96.6 million more than the two hospitals were authorized to bring in by the Green Mountain Care Board, Vermont’s primary health care regulator.Each year, the board sets caps on how much revenue Vermont hospitals can bring in from caring for patients. The caps are intended to limit the growth of health care costs for Vermonters.The 2024 financial figures have not yet been audited, and hospitals are still analyzing them, according to UVM Health Network administrators. But in 2024, according to the network, UVM Medical Center patient revenue exceeded the cap imposed by the Green Mountain Care Board by about $73 million, while Central Vermont Medical Center reported about $24 million in excess revenue.Patient revenue at the network’s third Vermont hospital, Porter Medical Center, came in about $4 million under the cap imposed in 2024.Administrators believe the extra revenue likely came in because hospitals have been providing care to more patients with more complex needs. If so, that excess — which health network administrators called a “variance” — would echo what happened in the previous year. In the 2023 fiscal year, UVM Medical Center and Porter Medical Center together came in roughly $90 million over the budget caps imposed by the Green Mountain Care Board.That variance was attributed to the fact that the network had “been delivering more care to sicker people,” UVM Medical Center President and Chief Operating Officer Stephen Leffler said in September.Network administrators emphasized that the extra revenue in fiscal year 2023 did not translate into excess profit for the hospitals. In fact, they said, hospitals lost money on delivering that care, because caring for those patients cost more than it brought in. It’s not yet clear if the excess revenue came at a loss in 2024 too.“We still need to dig into that specifically,” said Rick Vincent, executive vice president and chief financial officer at UVM Health Network. “(At) UVM Medical Center, I’m pretty confident that that’s going to be the case when we do the deeper dive. CVMC, not sure yet.”Mike Fisher, Vermont’s chief health care advocate, expressed concern about the 2024 variances in an interview. Patient revenue to hospitals, Fisher said, ultimately comes from premiums and out-of-pocket expenses paid by Vermonters and employers.“I am very concerned about health care providers across the state of Vermont that are at serious risk of insolvency, and continue to have real concerns about how stable our insurance companies are,” Fisher said. “And to hear that UVM Health Network is $100 million over is very upsetting.”UVM Medical Center’s 2024 fiscal year operating margin was about $62 million — less than the roughly $64 million the hospital had budgeted. Central Vermont Medical Center, however, had a $5.5 million operating margin that year, even though the network had budgeted for a $2.8 million loss. It’s not yet clear how regulators will react to the 2024 variance. Earlier this year, the care board ordered UVM Medical Center to reduce its charges to commercial insurance as a result of 2023’s excess revenue.That move added fuel to long-standing tension between the network and the health care regulator, and hospital leaders are currently appealing that decision.Kristen LaJeunesse, a spokesperson for the Green Mountain Care Board, said in an email that the board will receive finalized figures for 2024 from hospitals in January.“If (the hospitals’) financial reporting indicates they are out of compliance with its budget order, GMCB anticipates reaching out and asking for further explanation and related information,” LaJeunesse said.Read the story on VTDigger here: UVM Health Network hospitals will exceed budget caps again.