Concerns regarding the environmental impacts of hospitals have made the healthcare sector one of the most prominent settings for the green building movement. Despite these environmental concerns, the number of studies that document the benefits of sustainable healthcare facilities is limited. In this study, the authors used the Medicare and Medicaid cost report data to compare the financial performance of 14 Leadership in Energy and Environmental Design (LEED) certified hospitals against the average performance of non-green facilities. In line with studies conducted in other settings, the authors found that there are low and high performers among green hospitals. For this study, green hospitals had higher facility operating expenses than an average non-green hospital and spent more on plant operations. While green hospitals included in this study generated more revenue, the incomes were not high enough to validate the high operating expenses.

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Author notes


Research Scientist, College of Human Ecology, Department of Design and Environmental Analysis, Cornell University,


Associate Professor of Practice, Zachry Department of Civil Engineering, Texas A&M University,


Graduate Student, Industrial and Operations Engineering, University of Michigan,