Episode Summary: "Reimagining Rural Health Care in Vermont with Anna Tempesta Noonan"
Becker’s Healthcare Podcast | February 17, 2026
Guest: Anna Tempesta Noonan, President, Central Vermont Medical Center
Host: Scott Becker
Overview
In this episode, Scott Becker speaks with Anna Tempesta Noonan, President of Central Vermont Medical Center (CVMC), about the evolving landscape of rural healthcare in Vermont. The conversation explores key challenges such as aging populations, staffing shortages, high healthcare costs, and the need for innovation and collaboration. Anna also discusses opportunities brought by federal funding, regionalization of care, and advice for emerging healthcare leaders.
Guest Introduction and Background
[01:15 – 02:48]
- Anna Tempesta Noonan is a nurse by background, celebrating 45 years in healthcare and 30 years in executive leadership roles.
- She has been CVMC’s president for nine years.
- CVMC is the largest community hospital within the University of Vermont Health Network, serving a largely rural area with a catchment of 68,000 and about 1,500 employees.
- The University of Vermont Health Network includes:
- 1,465 beds across the system (including a 562-bed academic medical center and five community hospitals)
- 16,000 employees and 141 outpatient sites.
Rural Health Care Challenges and Trends
Unique Rural Considerations
[03:46 – 06:46]
- Vermont is “one of the healthiest states in the country” with low unemployment and low uninsured rates.
- “Affordability of healthcare in Vermont is a critical issue… Vermonters are noted as paying some of the highest prices nationwide for individual health coverage.”
- End of ACA enhanced tax credits has tripled premiums for some residents.
- High drug cost inflation, especially with specialty meds like GLP-1s.
- Aging Population:
- “Roughly a quarter of Vermonters are in the 65 plus range, and Central Vermont...the only demographic that's really increasing in numbers is over 65.”
- Staffing Challenges:
- Recruitment of providers is somewhat aided by the academic network.
- Other roles (e.g., nurses, respiratory therapists) are harder to fill, prompting the development of local talent pipeline programs for career progression from LPN to RN and beyond.
- Hospital Sustainability:
- 2023: 9 of 14 hospitals had negative margins;
- 2025: 5 of 14 remain in the red.
- Heavily regulated health system, requiring strong partnerships with the state.
Notable Quote
“The only demographic that's really increasing in numbers is over 65. So our population is aged. And that has impacts also on staffing.”
— Anna Tempesta Noonan [05:01]
Impact of Aging Population on Rural Healthcare
[07:28 – 09:04]
- Increased need for intensive, complex care as population ages.
- Young people leaving Vermont reduces local workforce available to support elder care.
- Support structures are declining:
- “Many of our patients that are aged, their support systems don't live in our state. They live in other states and they live in urban areas.” [08:13]
- Other major challenges: housing for elders, daycare for staff, and mobility/transportation for patients.
Regionalization and Labor & Delivery Services
[09:43 – 11:03]
- Declining number of births is causing rural hospitals to close labor and delivery (L&D) suites; CVMC absorbing patients from recently closed nearby L&D sites.
- Regionalization is seen as both a challenge and “an opportunity…more regionalization of services so that we're staying relevant and appropriate around just pure volume.”
- Low patient volumes impact the ability to maintain quality care in specialized departments.
Notable Quote
“It's hard to keep the quality up when you have lower volumes of patients coming through a particular service. And that's certainly true for us in Vermont with the birthing centers.”
— Anna Tempesta Noonan [10:13]
Positive Developments: Federal Funding and Innovation
[11:11 – 12:45]
- Vermont awarded a $195 million Rural Health Care Transformation Grant from CMS, to be distributed over five years.
- Key priorities for the funds:
- Enhancing partnerships and collaborations statewide.
- Reengineering care delivery for a shrinking and aging population.
- Leveraging technology: AI, electronic health records.
- Much-needed infrastructure updates, given reliance on aging Hill-Burton Act-era facilities.
- Vermont’s small population (“approximately 647,000 individuals”) enhances collaboration across organizations.
Notable Quote
“We have an opportunity to really collaborate differently and think about some innovative opportunities to deliver high quality care to the communities we serve.”
— Anna Tempesta Noonan [12:34]
Leadership Advice for Emerging Leaders
[12:54 – 14:14]
- Prioritize building professional networks locally, regionally, and nationally.
- Leverage knowledge and best practices from diverse sources.
- Adapt and adopt strategies that accelerate performance in your own organization.
- Exhibit self-care and “wellness behaviors” as role models to maintain sustainability for future leaders.
Notable Quote
“Make space to take care of yourself. Health care is more challenging now than it's ever been...So being a role model to our teams and exhibiting wellness behaviors for the next generation of leaders I think is going to be critical for long term sustainability.”
— Anna Tempesta Noonan [13:50]
Closing Reflections: The Nature of Caring in Rural Vermont
[14:22 – 15:25]
- Vermont’s small, tight-knit communities shape the care environment:
- “You are literally taking care of your neighbors, your friends, your family in all the roles we serve in. So I think it brings the caring concept close to home and makes everything we do even more important.” [14:35]
- Anna expresses gratitude and pride in the culture and mission of CVMC.
Key Timestamps
- 01:15 – Anna’s career and CVMC profile
- 03:46 – Rural health challenges and Vermont context
- 05:01 – Impacts of the aging population
- 07:28 – Staffing and support system challenges
- 09:43 – Labor & delivery: regionalization and declining birth rates
- 11:11 – CMS grant and innovation priorities
- 12:54 – Advice for future healthcare leaders
- 14:22 – Reflections on the rural spirit of care
Memorable Quotes
- “Affordability of health care in Vermont is a critical issue...Vermonters are noted as paying some of the highest prices nationwide for individual health coverage.” — Anna Tempesta Noonan [04:09]
- “The only demographic that's really increasing in numbers is over 65.” — Anna Tempesta Noonan [05:01]
- “We have an opportunity to really collaborate differently and think about some innovative opportunities to deliver high quality care.” — Anna Tempesta Noonan [12:34]
- “Make space to take care of yourself. Health care is more challenging now than it's ever been.” — Anna Tempesta Noonan [13:50]
- “You are literally taking care of your neighbors, your friends, your family in all the roles we serve in.” — Anna Tempesta Noonan [14:35]
Summary
Anna Tempesta Noonan offers a candid look into the realities and hopes of rural health care leadership in Vermont. She highlights persistent challenges—ranging from eldercare and workforce shortages to hospital sustainability and infrastructure needs—while also expressing optimism about collaboration, innovation, and the impact of transformative funding. Anna closes with advice for those rising in the field and a reminder of the deep connections that define rural community healthcare.