============================================================================== CERTIFICATE OF NEED INTELLIGENCE BRIEF: VERMONT The Rojas Report | conlaws.rojasreport.com/states/vermont/ ============================================================================== State: Vermont (VT) Score: 100/100 Tier: Most Restrictive Rank: 43 of 51 jurisdictions ------------------------------------------------------------------------------ SUMMARY ------------------------------------------------------------------------------ Vermont scores 100/100 on CON restrictiveness. The Green Mountain Care Board holds both CON and rate-setting authority — unique in the nation. UVM Health Network dominates with 6 hospitals. ------------------------------------------------------------------------------ SCOPE OF REGULATION ------------------------------------------------------------------------------ * Regulated Services * Score 65. Northwell's $17.6B empire. 26 regulated services. The state that started it all in 1964. ------------------------------------------------------------------------------ APPLICATION PROCESS ------------------------------------------------------------------------------ Vermont's Green Mountain Care Board is the only regulatory body in the nation that combines Certificate of Need authority with hospital budget review and rate-setting power. This means the GMCB doesn't just decide who can build — it decides what they can charge. Reviews and approves hospital budgets annually ------------------------------------------------------------------------------ MARKET CONCENTRATION ------------------------------------------------------------------------------ Controls market entry for all major healthcare services Any project over $3M requires GMCB approval ------------------------------------------------------------------------------ REFORM STATUS ------------------------------------------------------------------------------ What Reform Would Look Like Compare all 35 jurisdictions. Interactive table with scores, tiers, and reform status. ============================================================================== Source: The Rojas Report | conlaws.rojasreport.com/states/vermont/ Data: Cicero Institute, NASHP, FTC, DOJ, CMS, state health departments Generated: April 2026 ==============================================================================