Business Office

Budget: Actual vs. estimated program budget

$121.14MilAug 2020

Line Bar
Notes on Methodology

Please note in the chart above that the $ amounts are cumulative;

  • the solid trend line shows the actual total cost of care (ATCOC)
  • the dotted trend line shows the estimated total cost of care (ETCOC)


  • AHS CO
  • Dept. of Finance and Management
  • State of Vermont Legislature – Joint Fiscal Committee
Story Behind the Curve

The Business Office (BO) tracks spending and enrollment trends by Medicaid Eligibility Group (MEG) and Category of Service (COS) as well as anticipated one-time costs, coordinates with the partners listed above, and creates a budget estimate for the fiscal year. Then, applying the historical spending trends that most closely resemble current experience, break down that annual amount into weekly spending estimates to create the 52 Points of Light dashboard.

The current overall trend for enrollment is up in some major MEGs, while spending is expected to reduce in some of the non-MEG based costs such as Buy in and Disproportionate Hospital Share (DSH). These factors combined create an overall up for both enrollment and spending budget each fiscal year.

DVHA aims for programmatic spending to be within 1% of appropriation. This KPI is informational only. The complexity of healthcare spending is largely outside of the scope of control of finance.

Last updated: 09/15/2020

  • The strategy behind the creation of the budget each fiscal year is to engage in the most rigorous analysis of the actual spending experience as possible, and then combine the knowledge gained from that with additional known factors such as one-time liabilities, expected price changes, expected population shifts, revenue requirements and limitations, and administrative and legislative initiatives.
  • Research trends in utilization and spend, engage with appropriate contacts.
Scorecard Result Container Indicator Measure Action Actual Value Target Value Tag S R I P PM A m/d/yy m/d/yyyy