JUNE 19, 2023


Thought Leadership

Greg Adams is chair and CEO of Kaiser Permanente.

David Entwistle is president and CEO of Stanford Health Care.

Dr. Rod Hochman is president and CEO of Providence.

Wright Lassiter III is CEO of CommonSpirit Health. 

The authors are members of the National Academy of Medicine’s Action Collaborative on Decarbonizing the U.S. Health Sector.

Embracing sustainability makes good business sense

The health sector accounts for almost 10% of greenhouse gas emissions in the United States. These emissions come from facility operations, purchased energy, the supply chain, investments in companies with large carbon footprints and other sources. Emissions harm health both directly and indirectly—for example, by contributing to increased hospitalizations for respiratory diseases and temperature-related deaths—and people in historically disadvantaged and underserved communities bear the disproportionate brunt of these impacts.


As health system leaders, our mission is to do no harm. In the face of the worsening climate crisis, it is clear that succeeding in this mission depends on prioritizing sustainability and reducing our carbon footprint. Yet, as provider organizations face sustained budget shortfalls, major operational changes can seem out of reach. The truth may be surprising: Embracing sustainability makes good business sense, even amid negative margins. It can actually reduce costs while enhancing the way we care for our patients and our employees. 

Many sustainability decisions are “low-hanging fruit”—cost-effective, easy to implement and capable of making an immediate impact. Think about how many lights are on in a hospital at given moment. Just by converting to LED lighting, facilities save energy and cut costs. At CommonSpirit Health, making this change in one state led to saving $10 million annually in energy costs. The organization is working to scale the effort across the system. Virtual visits present another opportunity for change in the short term. They are often more efficient than in-person visits and can reduce emissions and cut fuel costs, all while making healthcare more accessible.

Hospitals and health systems can measure and track their greenhouse gas emissions to help identify areas where they can most effectively make reductions. Putting processes in place to collect this information helps organizations get the most out of their environmental stewardship initiatives. For example, Providence developed the WE ACT Framework and Scorecard to focus on key areas of environmental stewardship—waste, energy and water, agriculture and food, chemicals and transportation—and identify, track and address emissions through systemwide data collection.


Our healthcare organizations are complex, and so are their environmental footprints, but setting short-term, achievable targets—especially those that produce early cost savings—helps integrate sustainability into our business. Stanford Health Care, for example, has successfully incorporated sustainability as a core organizational value, engaging employees along the way through departmental “Green Teams” that develop effective strategies for reducing emissions. Such approaches can create new professional development opportunities. Overall, an organization’s environmental commitment has the potential to boost employee engagement and recruitment.


Taking cost-effective, incremental steps now can make an immediate impact and build momentum for future work. Kaiser Permanente powers its facilities with 100% renewable electricity, and is driving toward net-zero emissions and achieving certified carbon-neutral status. But prioritizing sustainability is also a strategic long game. Although U.S. regulatory requirements are uncertain, emerging trends point to a demand for organizations to reduce their carbon emissions and become more sustainable. By acting today, hospitals and health systems will be ahead of the curve and may experience less disruptive transitions.

None of us can do this alone. Given the barriers to sustainability efforts, we must capitalize on opportunities to share successful approaches and common challenges broadly. Achieving sustainability in the health sector requires a consistent, collaborative effort. Collaboration is also cost-effective: By working together to share strategies and best practices, we save precious time and resources. The National Academy of Medicine’s Action Collaborative on Decarbonizing the U.S. Health Sector is an example of a knowledge-sharing community that can help members gain foundational skills in advancing sustainability.


It is also critical that we seek opportunities to change the landscape using the significant influence that we possess in so many areas. Our broader success can depend on changes in our society and economy at large. Health systems have a role here, too. Hospitals are anchor institutions in their communities and can use all of their assets—purchasing, investment, hiring—for equitable local economic impact. All of our advocacy teams have been instrumental in supporting laws like the Inflation Reduction Act, and in maintaining an ongoing conversation with the White House, Congress and leading national groups. This work is critical to the success of our own efforts and those of the sector.

Health systems should also partner with energy producers to advance policies and financial incentives that can help them implement emissions reduction measures faster. We should also reach out to supply-chain partners to influence and support their climate action plans and goals. Provider organizations need to evaluate the environmental impact of purchasing decisions and then set expectations for suppliers to, in turn, evaluate their own environmental impact. Together we can achieve greater alignment and create strategies for reducing the carbon footprint across the supply chain.
Hospitals and health systems have a stake in this issue and an important voice—and leaders have the power to act. Taking steps today toward sustainability makes clear financial sense and allows us to better care for the communities we serve, now and in the future. Doing this work is good for our patients, good for our caregivers and good for our business. We can’t afford not to do it. 

Reprinted with permission from Modern Healthcare. © 2023 Crain Communications Inc. All rights reserved.
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