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The following FAQs reflect questions submitted by UVA Health team members in the days leading up to the December 2025 Town Hall, during the forum, and immediately afterward. The categories represent the themes and topics most frequently raised via submitted questions. 

To ensure clarity and relevance for a broad audience, similar questions have been combined, topics have been grouped, and wording has been edited when appropriate. These edits were made to: 

• protect individual privacy and avoid identifying specific departments, clinics, or team members, and/or
• ensure the response is broadly applicable to a wider range of roles and settings across UVA Health.

Many questions originated from team members within specific entities or areas of the health system, and responses may vary depending on the entity. Where possible, responses have been clarified to indicate the most relevant setting; however, readers should be aware that not all questions and answers apply universally across UVA Health. 

Some submissions included individual personnel situations, active legal matters, or highly specific unit-level concerns that cannot be addressed in a systemwide FAQs format. When possible, those themes have been incorporated into broader responses, along with guidance on appropriate next steps and available resources. 

Financial Performance, Stewardship, and Preparing for Policy Change

1) How is UVA Health doing financially, and how are funds distributed or reinvested?

UVA Health’s financial performance has been strong early in FY26, with operating income exceeding budget expectations, supported by higher clinical volumes, favorable payor mix, and pharmacy growth.

Earnings are reinvested to advance mission priorities, including workforce compensation and staffing, facility and infrastructure needs, and other critical investments that support safe, high-quality patient care.

2) What are the most significant financial concerns heading into 2026, and could this lead to staffing or hiring impacts?

While UVA Health is performing well financially — operating income exceeded budget expectations early in FY26 — we are planning for potential headwinds tied to policy and coverage changes that could affect Medicare, Medicaid, and Affordable Care Act subsidies.

As fewer people remain insured, health systems may see more uncompensated care and increased pressure on already tight budgets. UVA Health is actively monitoring these developments and preparing through scenario planning so we can continue supporting our teams and meeting patient needs.

3) Many Virginians may lose Medicaid coverage in the coming years. How is UVA Health preparing for more uninsured or underinsured patients?

UVA Health is preparing for the possibility of increased numbers of uninsured and underinsured patients as Medicaid coverage changes across Virginia. As a mission-driven academic health system, we have long served as a safety-net provider, and that responsibility remains central to our planning.

Operationally, we are monitoring coverage trends and policy changes while building flexibility into budgeting and staffing models. We are also strengthening access pathways, care coordination, and financial counseling services so patients can better navigate coverage options and connect with available resources. Regardless of coverage status, UVA Health remains committed to providing timely, high-quality care.

Pay, Benefits, and Recognition

4) If UVA Health is exceeding budget, can team members — especially hourly roles — receive raises to keep up with cost of living?

UVA Health recognizes the impact of rising living costs on hourly and clinical team members. While financial performance has been strong early in FY26, we carefully plan how funds are reinvested to balance mission priorities, staffing needs, and compensation.

UVA Health regularly conducts comprehensive compensation reviews to help ensure pay remains competitive within the markets we serve and to provide opportunities for annual increases when possible. We also explore ways to reduce costs and strengthen total compensation, including keeping healthcare premiums as low as possible and providing other programs that contribute to team member well-being.

5) Why do many performance reviews land at “meets expectations,” and how does that affect raises or bonuses?

UVA Health uses performance management frameworks to promote fairness and consistency across roles and departments. “Meets expectations” reflects strong, reliable performance in demanding clinical and operational environments. Ratings above that level are intended to recognize truly differentiated performance and are therefore used more selectively.

Compensation growth is guided by market benchmarking, role scope, and performance — not tenure alone. Base pay increases and bonuses are not guaranteed annually and may vary based on market conditions and organizational priorities. UVA Health continues to invest in career pathways, role progression, and recognition opportunities so that growth can occur over time, even when base pay adjustments are limited.

6) How does UVA Health address “pay compression,” when newer hires earn more than long-term team members in the same role?

Pay compression is a challenge faced by many organizations in competitive labor markets. UVA Health monitors compensation through market reviews and pay equity assessments. When compression is identified, adjustments may be made over time through market-based increases, role progression, or other compensation actions. Experience, skill, and sustained contributions remain important factors in compensation decisions.

7) How does UVA Health think about differences between executive and employee pay?

Compensation at UVA Health is determined using market benchmarking appropriate to each role, level of responsibility, and scope of impact. Executive compensation is set through formal governance processes and reflects national benchmarks for academic health system leadership.

At the same time, UVA Health is committed to supporting team members at all levels through competitive pay, comprehensive benefits, and investments in career development and recognition — so people can build stability and long-term growth across the workforce.

8) Some roles feel underpaid (for example, Medical Assistants, pharmacy technicians, and other frontline support roles). What is being done?

UVA Health regularly reviews compensation using market data and internal pay equity considerations and conducts regular compensation assessments. We recognize the essential contributions of roles that support patient access, clinic flow, safety, and the care experience.

In addition to periodic market adjustments, UVA Health continues to build clearer career pathways, ladders, professional development opportunities, and differentiated recognition so team members can grow earnings and expand responsibilities over time.

9) For team members at the top of a pay range (for example, nurses at the top of a clinical ladder), how can UVA Health retain expertise at the bedside?

UVA Health values the expertise and dedication of veteran clinicians and recognizes the importance of retaining experienced team members at the bedside. While some roles may be capped within a pay band, UVA Health is focused on clearer pathways for growth, advancement, and differentiated recognition — including opportunities to take on advanced or specialty responsibilities. Additionally, we perform regular market assessments and adjust pay bands appropriately, allowing for additional compensation growth over time. 

Retention of highly skilled professionals remains a priority, and UVA Health continues working to align incentives with both individual growth and unit needs, while balancing long-term sustainability.

10) Can we expect performance raises for those who consistently go above and beyond?

UVA Health values high performance and dedication. Performance is a factor in compensation and advancement decisions, but performance, also referred to as merit, raises are considered within the context of market conditions, role scope, and overall financial performance and are not guaranteed annually.

Recognition can take multiple forms over time, including career progression, expanded responsibilities, market-based adjustments, and recognition programs.

11) Why aren’t annual bonuses guaranteed, and what is the status of the ASPIRE bonus program?

Bonus programs have evolved over time based on financial performance, workforce priorities, and broader economic conditions. UVA Health has focused on investments in base compensation and benefits, rather than guaranteed annual bonuses.

ASPIRE Bonus Program: Yes — the University Medical Center bonus program was reinstated in early 2026. While minor adjustments have been made to the approval process, most eligible University Medical Center team members should not experience significant changes. Leadership will continue evaluating all recognition programs across the health system to ensure they remain meaningful and aligned with UVA Health values.

12) Why don’t all roles receive separate holiday pay?

UVA Health University Medical Center provides a paid time off (PTO) plan that combines leave for holidays, sick time, personal business, and other purposes into a flexible pool. This approach supports different roles and schedules across inpatient and ambulatory settings and is designed to promote fairness and flexibility while maintaining the operational continuity required to care for patients.

UVA Community Health takes a slightly different approach where paid holidays are separated from the flexible pool of PTO hours.

13) Why must timecards still be approved on Mondays that fall on holidays?

To ensure team members are paid on time each Friday, timecards for team members in some UVA Health entities must be approved by Monday according to the payroll schedule. Shifting the deadline could jeopardize payroll processing.

When a Monday is a holiday, managers are encouraged — when possible — to review and approve timecards by the end of the preceding week.

14) Could UVA Health explore a four-day, 32-hour workweek in certain areas?

UVA Health recognizes that alternative work models can support engagement and well-being. Our HR teams will explore this concept and evaluate how it could align with operational needs, team priorities, and patient care requirements. No immediate changes are planned, but the idea will be considered as part of ongoing discussions about workforce flexibility and well-being.

15) What is UVA Health doing to reduce employee health insurance costs?

UVA Health team members fall into multiple employment categories and are eligible for various insurance plans depending on their employment entity. As a system, UVA Health evaluates benefits offerings each year — including plan designs, deductibles, and cost sharing — in partnership with benefits experts and carriers. Rising healthcare costs affect employers nationwide, and plan changes reflect efforts to balance affordability with long-term sustainability.

Leadership remains focused on offering competitive benefits while exploring strategies that support team member well-being and manage costs responsibly.

16) Dental coverage feels limited (for example, annual maximums). Can UVA Health enhance dental benefits or offer lower-cost options through UVA clinics?

UVA Health understands the financial strain that dental costs can create. Benefits are reviewed regularly as part of overall total rewards planning, balancing affordability for team members with sustainability of the benefits program. Suggestions such as exploring additional options or structures (including potential internal clinic-based approaches) are valuable and help inform future benefits discussions.

17) Will UVA Health consider student loan repayment as a benefit?

UVA Health recognizes that student loan repayment programs can be an important recruitment and retention tool in competitive labor markets. This is an area that can be evaluated as part of a broader total rewards strategy, considering affordability, operational feasibility, and where such programs would most effectively support workforce needs.

Parking, Transportation, and Commuter Safety

18) What is UVA Health doing about the parking and transportation challenges, particularly in the Charlottesville/Albemarle area?

As UVA Health has grown in and around the University Medical Center, infrastructure — especially parking and transportation — has not kept pace. Parking remains a significant concern for team members across UVA Health and the broader UVA ecosystem.

Leadership is taking a comprehensive approach that includes both near-term improvements and longer-term planning. Key areas of focus include:

• improving lighting and visibility
• strengthening pedestrian safety
• increasing shuttle reliability, routing, and frequency
• improving wayfinding and signage
• using technology to improve awareness of garage capacity and shuttle timing

An employee parking advisory committee has been established to ensure frontline perspectives inform improvements. Long-term solutions will require structured parking investments, which take time and planning, but leadership is actively considering options as part of broader growth planning efforts. 

19) Why are gates up/open at University Medical Center’s South Garage, and how is enforcement working?

Parking and Transportation is transitioning South Garage to a gateless system using License Plate Recognition (LPR) technology — consistent with other UVA parking locations. Although gates are currently up, license plate readers support monitoring and enforcement to ensure compliance with parking practices. 

20) What’s the latest on commuter parking locations (for example, Emmet/Ivy to Fontaine) and related shuttle timelines at University Medical Center?

One key dependency has been completion of the Purple Line, which is now in operation. As of March 9, 2026, UVA Health and Parking and Transportation relocated commuter parking from Emmet/Ivy Garage to Fontaine Research Park Garage to support institutional growth and manage parking demand at Emmet/Ivy Corridor for academic, hotel, and development needs. The Fontaine Garage includes 1,248 parking spots on seven levels and does not include patient parking. The new Purple Line runs continuously, from 7 a.m. to 8 p.m., between Fontaine Research Park and various University Medical Center stops. 

21) Will UVA Health expand patient parking?

Patient parking is included in broader parking and transportation planning. UVA Health recognizes the frustration patients and families experience and is working toward more coordinated, sustainable solutions as part of long-range planning.

Facilities, Space, and Capacity Planning

22) Is West Complex in Charlottesville going to be renovated or replaced?

Yes. West Complex is included in capital project renovations and is part of the master facilities planning process.

23) What is UVA Health’s plan for clinics, operating rooms, inpatient beds, and overall space constraints (near-term, three-year, five-year)?

UVA Health is taking a phased, long-term approach to space constraints that balances immediate operational needs with thoughtful planning. In the near term, the focus includes optimizing existing space, expanding ambulatory capacity, and making targeted investments where demand and access needs are greatest.

Looking ahead, planning includes a mix of ambulatory growth, inpatient and procedural capacity expansion, and infrastructure investments that support safe, high-quality care. These decisions are informed by projected patient volumes, workforce needs, and responsible financial stewardship. Rather than a single solution, UVA Health is pursuing a portfolio of strategies across short-, medium-, and long-term horizons.

Strategy, Growth, and Primary Care Access

24) What progress has been made on UVA Health’s strategic plan, and are we on track?

UVA Health’s strategic plan continues to guide decision-making across clinical care, research, education, and community engagement. Progress includes expanding access, strengthening regional partnerships, investing in the workforce, and advancing clinical excellence and discovery — efforts visible through ambulatory expansion, targeted service growth, and deeper collaboration across the Commonwealth.

Challenges include workforce pressures, space constraints, and evolving reimbursement models. The strategic plan is designed to be durable and adaptable, so UVA Health can respond to changing conditions while staying focused on long-term goals.

25) What is UVA Health’s primary care and ambulatory strategy — especially to improve access?

Increasing access to primary care remains a critical need for our community and for UVA Health team members. UVA Health is pursuing multiple opportunities to expand access points, including recent ambulatory growth such as the Zion Crossroads expansion (expected to support significant additional appointment capacity) and new access points in regions like Culpeper.

Primary care access is essential to UVA Health’s long-term goals, and we will continue seeking ways to increase capacity, improve scheduling, and strengthen care coordination.

26) Is UVA Health’s vision to become a large health system like Johns Hopkins, West Virginia University, or Duke?

UVA Health’s vision is to be the leading public academic health system in the country — rooted in excellence in patient care, education, and research; not growth for growth’s sake.

Growth decisions are made strategically and are evaluated based on mission alignment, community benefit, and value to patients. Sometimes that takes the form of scale; other times it takes the form of focused partnerships and affiliations, such as collaboration with Riverside Health System in Eastern Virginia or clinical partnerships like the pediatric congenital heart collaborative with Children’s Hospital of the King’s Daughters.

27) How is UVA Health balancing fee-for-service and value-based care, and how will specialists be engaged?

UVA Health recognizes that value-based care requires engagement across the continuum, including specialists and specialty clinics. As we continue operating with both fee-for-service and value-based arrangements, we are focusing on stronger care coordination, shared accountability for outcomes, and improved connections between primary and specialty care.

Leadership messaging emphasizes that value-based care is not limited to primary care. Specialists play a key role in improving outcomes, reducing unnecessary utilization, and supporting continuity for complex patients. Chairs and operational leaders are being encouraged to align workflows, data, and care models in support of these goals.

28) What is UVA Health’s vision for expanding primary care in Charlottesville while maintaining continuity?

UVA Health’s approach to primary care growth is centered on expanding access while preserving the relationships that support high-quality care. This includes increasing capacity through new access points, team-based models, and thoughtful use of technology while prioritizing continuity through improved scheduling, panel management, and care coordination.

Culture, Feedback, and Speaking Up

29) What is UVA Health doing to evaluate and improve organizational culture across clinical, business, and Health Information Technology (HIT) teams?

Executive leadership has identified culture as foundational to UVA Health’s success — especially as we continue navigating change. Leaders are focused on strengthening connection to mission, improving communication across teams, and supporting leaders in active listening and responsiveness.

A key focus is evaluating and reaffirming the values that guide behavior across the organization. Leadership is reviewing the ASPIRE values and seeking broad team member input to ensure they reflect lived experience and support collaboration, trust, and accountability. Team members can expect opportunities to share input through engagement surveys and other feedback mechanisms that will inform culture-focused initiatives and leadership development efforts.

30) Where can team members go if they have raised concerns locally and feel nothing is changing — or fear of retaliation?

UVA Health has established a dedicated Ombuds role to provide an independent, confidential resource when concerns cannot be resolved at the local level. The Ombuds serves as a neutral listener who helps individuals explore options, navigate challenges, and identify appropriate resources for conflict resolution and problem solving.

This role was created in response to team member feedback and is intended to provide a safe, trusted outlet — particularly in complex or sensitive situations. The Ombuds operates independently from leadership structures and supports employees across the health system.

31) Will UVA Health use exit interviews (including for internal transfers) and strengthen anonymous feedback options?

UVA Health is committed to listening to frontline team members and learning from their experiences. We continue strengthening approaches to gathering feedback through multiple avenues, which may include exit interviews, surveys, listening sessions, and anonymous submission tools. These mechanisms help leadership understand unit-level challenges, improve retention, and foster psychological safety and continuous improvement.

32) Engagement survey results from recent years were not shared with my department, and it feels like little has changed over time. With new leadership, should we expect more meaningful follow-throughs on employee feedback?

Thank you for raising this concern. It’s understandable to feel frustrated when feedback is shared, but the results or next steps aren’t clearly communicated at the local level.

As we prepare for the upcoming engagement survey (May 4-18), we are placing greater emphasis not just on participation, but on what happens afterward — including clearer sharing of results, structured post-survey planning, and more consistent action planning at both department and system levels. The goal is to strengthen accountability and ensure survey feedback leads to visible, meaningful improvements in team members’ day-to-day experience.

Public Policy and External Advocacy

33) What is UVA Health doing to address harmful state or federal directives that could affect research funding, Medicaid/Medicare, and patient access?

UVA Health is actively engaged — at both state and federal levels — in coordinating advocacy efforts regarding policies that could negatively affect academic medicine, research, and access to care. Working closely with University of Virginia partners, External Affairs leadership is involved regularly to help policymakers understand real-world impacts on patients and communities.

This work includes collaboration with national associations and coalitions, joint letters with peer academic medical centers, participation in formal public comment processes, and direct conversations with elected officials and staff. While not all details can be shared publicly, sustained advocacy is underway and remains a priority.

34) Has UVA Health completed a final review of anticipated impacts from new laws in 2026?

UVA Health is monitoring state and federal policy changes that could affect 2026 budgets and operations. Initial modeling and scenario planning have been completed, and broader analysis continues as the policy landscape evolves. Throughout this process, UVA Health remains focused on mission priorities, supporting our teams, and advocating for policies that promote the well-being of patients and the workforce.

35) How will new state leadership impact budgets and strategic plans over the next three years?

The transition to new state leadership is an important onboarding period, and engagement is already underway. External Affairs leaders are working with the incoming administration to share UVA Health’s strategic priorities, and the role academic medicine plays in workforce development, community health, and the Commonwealth’s economy.

Budget and policy implications will become clearer once proposed legislation is introduced during the General Assembly session. UVA Health will refine advocacy priorities accordingly, with attention to issues such as Medicaid policy and funding and other programs closely tied to health outcomes. We also coordinate with organizations such as the Virginia Hospital and Healthcare Association on shared priorities including workforce sustainability, rural health needs, and physician retention.

Technology, AI, and Telehealth

36) What is UVA Health’s perspective on artificial intelligence (AI) in healthcare, including concerns about bias, privacy, and trust?

UVA Health views AI as an increasingly important tool across clinical care, research, and operations, with potential to reduce administrative burden and improve efficiency. At the same time, AI must be adopted thoughtfully, with close attention to ethics, bias, patient privacy, and long-term impacts.

Where AI is already being used, it is applied in carefully defined, low-risk ways — for example, AI scribe functionality within Epic to reduce documentation burden while maintaining strict privacy and security standards. AI is also supporting research and operational optimization in defined use cases.

UVA Health is taking a cautious approach to any AI that could influence clinical decision-making. Before implementing such tools, the goal is to create secure testing environments to evaluate performance, safety, and bias without exposing patients to unproven systems. Maintaining patient trust, clinical integrity, and transparency will remain central.

Weather Operations, Safety, and Continuity of Care

37) Recent weather incidents have felt mismanaged. How are decisions made, and how will transparency improve — especially around telehealth?

UVA Health recognizes the frustration raised about recent weather-related incidents. Weather-response processes prioritize patient safety and continuity of care, and there is ongoing work to improve clarity, consistency, and lead time for team members and providers.

During potential weather events, UVA Health follows a structured decision-making process. Early each morning (often beginning around 4:30 a.m.), leaders assess transportation and bus operations, followed by coordinated calls between approximately 5 and 6:30 a.m. involving health system and ambulatory leaders. Operations are organized into defined geographic and functional zones to account for variable conditions. Leaders determine whether to proceed with standard operations, delay openings, close locations, or shift appropriate care to telehealth.

After significant weather events, UVA Health conducts debriefs to assess what worked and what needs improvement, using that feedback to strengthen transparency, communication, and proactive planning — including clearer guidance around telehealth where appropriate.

38) If a clinic closes due to weather or facility issues, why do team members need to use PTO or take leave without pay?

When University Medical Center clinics close due to circumstances beyond employees’ control, UVA Health must balance fairness to staff with operational realities of a large healthcare system. PTO provides a consistent approach across different roles and settings while supporting continuity of pay practices. This approach also helps UVA Health manage unexpected disruptions responsibly while continuing to prioritize patient care and systemwide sustainability.

Patient Billing, Access, and Service Experience

39) Is UVA Health improving patient billing transparency and cost estimates — especially for clinic-administered medications?

Yes. UVA Health is working to improve patient access to accurate cost estimates, aligned with federal requirements under the No Surprises Act and hospital price transparency regulations. Tools are available through MyChart and the patient billing office to provide advance estimates for scheduled services and anticipated out-of-pocket costs.

Healthcare pricing can be complex due to clinical variability and insurance benefit design differences. UVA Health continues enhancing Epic-based tools and processes to improve estimate accuracy and patient understanding.

Operational Suggestions and Continuous Improvement

40) Can we implement regular power washing/cleaning for hospital wheelchairs?

Thank you for the suggestion. UVA Health is open to exploring the feasibility of an ongoing, scheduled cleaning program for wheelchairs as an important consideration for cleanliness, safety, and patient experience. Operational teams (such as Hospitality/Guest Services and Facilities partners) can help evaluate current workflows and what would be needed to implement a sustainable schedule.

41) Can Rewards and Recognition events be improved for different sites and break schedules (for example, options like gift cards or alternate formats)?

Thank you for this feedback. Suggestions about more flexible approaches — such as alternative meal formats, gift cards, or choice-based options — will be shared with the Rewards and Recognition team for consideration, recognizing that team member schedules and site logistics vary widely.

42) Can OR readiness processes be adjusted (for example, requiring surgeon verification rather than resident sign-off)?

Thank you for the suggestion. This feedback will be shared with OR leadership for review and consideration within existing safety and workflow protocols.

Looking Ahead

43) So much has changed across UVA Health in the past several months. How do we recover?

The 2025 time period has brought significant change across UVA Health, and it is reasonable to acknowledge the weight of that experience. Recovery begins by keeping our mission at the center of our focus and allowing it to guide decisions, priorities, and how we show up for one another and for those we serve.

UVA Health has navigated cycles of uncertainty and transition for nearly 200 years and continued moving forward because of the commitment and perseverance of its people. Rebuilding trust takes time, and trust is foundational to everything else we are trying to accomplish. Maintaining open dialogue, speaking up when something needs to improve, and engaging constructively in solutions are essential. Recovery is not the responsibility of any one group alone — it will take all of us, working together with honesty, patience, and shared purpose.