Health Care Sector Role in Emissions Reductions

Climate change poses a significant threat to health care infrastructure and operations. Consistent with health care’s mission to first do no harm, it is imperative for the health care sector to mitigate its own contributions to climate change. The health care sector accounts for over 8% of United States (U.S.) greenhouse gas emissions.^a65 Despite this large footprint, there is wide variation across health systems in efforts to reduce health care emissions and waste and to prepare for climate-driven disruptions to health care delivery.^{a66, a67}

The Biden Administration has taken steps to support the health care sector in reducing emissions by 50 percent by 2030 and achieving net-zero emissions by 2050, in alignment with U.S. climate goals. The Administration now requires all federal facilities — including federally managed hospitals and health facilities — to align their actions with U.S. emissions reduction goals.^a68 In 2022, the Department of Health and Human Services launched the Health Sector Climate Pledge and encouraged non-federal hospitals, health systems, health associations and other industry organizations to voluntarily commit to meet the Administration’s climate goals.^a69 As of June 2022, 61 entities, including health systems representing 650 hospitals, have signed the pledge. This is an important first step, and yet represents only a small fraction of U.S. hospitals. Additional leadership is needed to mobilize more health care partners and to ensure participating organizations fulfill their climate pledges. Health care systems can invest more resources into decarbonization. Simultaneously, the Inflation Reduction Act (IRA) may lower the cost of the energy transition by expanding access to tax credits for non-profit hospitals to switch to clean energy sources.^a70

In addition to these federal efforts, the National Academy of Medicine (NAM) formed the Action Collaborative on Decarbonizing the U.S. Health Sector — a public-private partnership of health care stakeholders working to develop goals and strategies to decarbonize the health care supply chain and health care delivery, and expand health professional education on climate change.^a71 A focus of the NAM work is to develop policies, innovation, and metrics that support organizations in reducing their emissions. About 80 percent of all health care sector emissions stem from activities of assets not owned or controlled by health care organizations (so called “Scope 3”) and cannot be ignored. These include emissions from the supply chain, including the manufacturing, transport and disposal of food, pharmaceuticals, and medical supplies and devices.^a72 The Agency for Health Care Research and Quality provides guidance on metrics and strategies to track and reduce carbon emissions from buildings, transportation, anesthetic gases, pharmaceuticals, medical devices and supplies, and food systems and waste.^a73

Meeting climate goals, however, will require rapid and dramatic emission reductions from the entire health care sector while recognizing that voluntary action may be insufficient to achieve the Administration’s goals and timelines. Other actions that could accelerate health sector decarbonization include: mandated reporting of all health sector emissions; linking Centers for Medicare & Medicaid Services (CMS) accreditation and payment to annual, transparent, verified, and standardized disclosure of emissions; and incentivizing low-emission health care delivery choices by clinicians and health systems.^{a65, a74} Hospitals and health systems must also work with communities and public health partners to prepare for climate impacts by mapping needs, building climate resilient infrastructure and care delivery pathways, empowering vulnerable communities, strengthening climate change and health literacy among the health care and public health workforce, and ensuring equitable access to care.^{a67, a75}