Pennsylvania hospitals policy and sustainability dashboard

Executive brief for advocacy and policy decisions: current pressure, 2030 scenarios, and practical levers that affect access, workforce, and hospital stability.

Hospitals as Economic Engines

Tap a metric below. The detail panel updates to show that measure—so you always see the number and context for what you selected.

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Share of state GDP19%Hospitals' share of the Commonwealth's GDP. Total economic output$195BDirect and indirect contributions statewide. Community benefit$10.8BMedicare/Medicaid shortfalls, charity, bad debt. Jobs supported300,000Employed directly by hospitals in PA. Wages and benefits$33B+Wages and benefits paid by hospitals.

Viewing: Share of state GDPTotal economic outputCommunity benefitJobs supportedWages and benefits

Hospitals' share of the economy

Hospitals' direct and indirect activity represents about 19% of Pennsylvania's GDP.

Impact: Policy choices that weaken hospital stability ripple into statewide GDP and local business activity.

Total statewide economic output

Hospitals generate roughly $195 billion in total economic activity across the Commonwealth.

Impact: Hospitals are anchor institutions, so reimbursement and regulatory policy have economy-wide effects.

Community benefit and safety-net role

Hospitals provide about $10.8 billion in community benefit, covering public program shortfalls, charity care, and bad debt.

Impact: Margin compression can force tradeoffs that reduce mission-driven community services.

Hospitals as major employers

Hospitals directly employ more than 300,000 Pennsylvanians, in addition to supporting many more jobs through supply chains.

Impact: Financial instability threatens both access to care and regional employment resilience.

Wages and benefits

Hospitals pay over $33 billion in wages and benefits, sustaining families and local economies statewide.

Impact: Sustainable hospital finances are essential to maintain competitive health care workforce compensation.

HAP position

Pennsylvania hospitals · CEO briefing

Align policy with the cost of care

The sections below quantify pressure on Pennsylvania hospitals. HAP asks state and federal leaders to set payment and rules that match what it costs to deliver care—so communities keep access and hospitals can invest for the long term, not just survive the quarter.

What leaders can prioritize

Match public and private payment to the cost of care

Impact: Hospitals can cover labor, supplies, and community benefit without chronic operating losses.
Protect access in rural and underserved communities

Impact: Patients keep local options when anchor hospitals remain financially viable.
Support workforce and infrastructure investment

Impact: CEOs can plan beyond short-term fixes when capital and staffing are fundable.

Today's Financial Reality

Despite disciplined cost management and below-average costs per discharge, many hospitals are under sustained financial pressure.

Operating margins, 2024

How many hospitals are financially healthy vs. struggling? Bars show the share of PA hospitals in each category.

51%

Struggling (below 4% profit)

37%

Losing money

In plain terms: 51% of PA hospitals earn too little to thrive, and 37% are in the red—spending more than they take in.

What hospitals get paid vs. what care costs

100% = hospitals are fully paid for care. Bars below 100% mean hospitals absorb the shortfall.

71%

Private insurance (PA)

87%

Medicaid (PA)

82%

Medicare (PA)

Medicaid and Medicare pay hospitals less than the cost of care. Hospitals make up the difference or cut services.

Closures to date

25 hospitals have closed in Pennsylvania since 2016.

Each dot = one hospital that has closed since 2016.

25 facilities closed (2016–present)

Impact: Every closure increases travel burden and can weaken emergency and obstetric access in nearby communities.

Bond ratings

Lower ratings = higher borrowing costs. PA hospitals pay more to borrow than the national average.

Category	Pennsylvania	National
Hospital systems	A	A+
Stand-alone hospitals	BBB+	A-

Impact: Higher borrowing costs can delay infrastructure, technology, and workforce investments patients depend on.

2030 Financial Scenarios

By 2030, Pennsylvania hospitals could end up in very different financial positions depending on policy and the economy. Positive (cool) = hospitals earn more than they spend. Negative (warm) = hospitals spend more than they take in.

Possible 2030 outcomes: hospital profit or loss

Left of the line = hospitals lose money. Right = they earn. Further right = healthier.

-11% Rainy Day (Downward Cycle)

-3% Baseline with H.R. 1

-1% Baseline (No H.R. 1)

+5% Sustainability Prevails (Upward Cycle)

Rainy Day (Downward Cycle) — -11%

12–14 additional hospitals could close by 2030.
Higher unemployment reduces Commercial coverage.
Medicare sequestration increases to 4%.
Loss of 340B discounts increases drug costs.

Baseline with H.R. 1 — -3%

95,000 fewer ACA enrollees, 300,000 fewer Medicaid enrollees.
Medicaid payments capped at Medicare rates.
Higher uncompensated care.

Baseline (No H.R. 1) — -1%

Population ages, shifting more patients into Medicare.
Medicaid and Medicare reimbursement grow more slowly than costs.
Enhanced ACA subsidies expire.

Sustainability Prevails (Upward Cycle) — +5%

Commercial reimbursement rises to national median.
Medical liability reform reduces premium costs.
AI and operational improvements enhance productivity.

Access and Community Impact

Hospital closures and service reductions translate into longer travel times, fewer local jobs, and diminished economic activity.

Closures in a Rainy Day path

If we don't act, this many more hospitals could close by 2030.

12–14

additional hospitals could be forced to close without intervention.

Impact on communities

These are the impacts

Without action, affected communities would face:

+22 minAdditional drive time to nearest hospital and ER

3,000+Local jobs at risk

$900M+Lost wages tied to hospitals alone

Policy Levers: Moving Toward Sustainability

State leaders control several levers. Choose a path below to see what happens by 2030: no changes, or action on reimbursement, liability, and other factors.

What happens if we act—or don't?

No changes — stay the course With policy action

-11% Where we're headed

Hospitals lose money. Higher risk of closures. Communities lose access.

Impact: The no-action path compounds closure risk and local economic disruption by 2030.

+5% Where we could land

Hospitals are financially healthy. Services preserved. Communities stay connected.

Impact: Policy action improves odds of service continuity, access preservation, and long-term reinvestment.

Levers the state can adjust

Medicaid reimbursement — Current, Improved, or Transformed

Medical liability — Current, Reformed, or Strong reform

Administrative burden — Unchanged, Streamlined, or Modernized

Workforce & AI — Limited, Targeted, or Broad

Methods and Sources

This dashboard summarizes key findings from "Time to Act: What The Future Holds For Pennsylvania's Hospitals, Patients, and Communities" (January 2026). Prepared by Oliver Wyman for HAP.

Quantitative values are from the report text and endnotes.
Scenarios based on Baseline, Baseline with H.R. 1, Rainy Day, and Sustainability Prevails paths.

Data as of January 2026 (report date). Update this line when the underlying report or HAP synthesis is revised.

Impact: A clear date stamp helps executives and policy teams avoid using stale assumptions in testimony, negotiation, or board decisions.