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New Data Show Essential Hospitals’ Limited Resources as Pandemic Began


Statement attributable to:
Bruce Siegel, MD, MPH
President and CEO
America’s Essential Hospitals

WASHINGTON—In the year before they led the nation’s costly response to COVID-19, essential hospitals operated with margins a third that of other U.S. hospitals and provided a disproportionate amount of charity care, new data from America’s Essential Hospitals show.

An analysis of the association’s more than 300 members—about 5 percent of all U.S. hospitals—shows they delivered a quarter of all charity care and 17 percent of uncompensated care nationally in 2019 and operated with an average margin of 2.9 percent versus 8.8 percent at other hospitals.

“These numbers speak to the remarkable commitment and resiliency of essential hospitals in the fight against COVID-19,” said America’s Essential Hospitals president and CEO Bruce Siegel, MD, MPH. “They began with almost no cushion against the pandemic’s high costs yet still met the needs of communities most affected by COVID-19—and continue to do so today.”

The new data on essential hospitals comes in the association’s annual snapshot of its members, Essential Data: Our Hospitals, Our Patients. The report also found the average essential hospital provided seven times as much uncompensated care, more than twice as many emergency department visits, and nearly three times as many nonemergency outpatient visits as other U.S. hospitals in 2019.

Essential Data shows 51 percent of essential hospital discharges in 2019 were people from racial and ethnic minority groups and three-quarters were uninsured or covered by Medicaid or Medicare. Essential hospitals’ safety net mission also is reflected in the communities they serve, where nearly 10 million people had limited access to healthful food, 370,000 experienced homelessness, 14.4 million had no health insurance, and more than 22 million lived below the poverty line in 2019.

“Essential hospitals have long cared for communities where social determinants of health, systemic barriers to care, and structural racism magnified the damage COVID-19 caused,” Siegel said. “That experience made them invaluable resources in our pandemic response.”

In addition to their core role of caring for marginalized populations, essential hospitals provide communities at large with complex, lifesaving services and contribute significantly to local and state economies. In 2019, essential hospitals:

  • operated a third of the nation’s level I trauma centers and about 40 percent of all burn care beds;
  • trained an average of 240 physicians per hospital versus 84 at other teaching hospitals; and
  • employed about 3,200 people per hospital and had total expenditures of about $125 billion nationally.

Essential Data: Our Hospitals, Our Patients, is available on the America’s Essential Hospitals website.

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About America’s Essential Hospitals
America’s Essential Hospitals is the leading champion for hospitals and health systems dedicated to high-quality care for all, including the most vulnerable. We support our more than 300 members with advocacy, policy development, research, and education. Communities depend on essential hospitals to provide specialized, lifesaving services; train the health care workforce; advance public health and health equity; and coordinate care. Essential hospitals innovate and adapt to lead the way to more effective and efficient care. Learn more at

Carl Graziano


About the Author

Dedicated staff at America's Essential Hospitals work together to produce high-quality, reliable content. Please view the about section for more details about staff.

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