Healthcare is one of North Carolina’s most important economic drivers, with health systems and hospitals supporting 1 in 8 North Carolina jobs and contributing 6 percent of the state’s entire gross domestic product, an analysis by RTI International has found based on an analysis of 2020 data.  

The report, commissioned by the North Carolina Healthcare Association, reveals that North Carolina hospitals and health systems – both directly and through the ripple effects of their economic activity – benefit communities and the state by:  

• Contributing $40 billion in gross domestic product (GDP) impacts, which translates to about 6% of total state GDP 

• Supporting 515,000 jobs, or 8% of all jobs in the state, by providing 268,000 direct jobs and supporting an additional 247,000 jobs in other industry sectors 
• Generating $29 billion in wages, salaries and benefits 

“This study demonstrates that NCHA member hospitals and health systems are major players in economic development in North Carolina,” NCHA President and CEO Steve Lawler said, adding that hospitals are among the top job-creating sectors in the state.  

Some key findings of the analysis include:  

• 92 of North Carolina’s 100 counties have at least one hospital among their top 10 employers, and in 45 counties a hospital is a top 3 employer 
• New healthcare construction, a $3 billion dollar activity in 2020, supported more than 13,000 jobs in the construction industry. This construction is needed to ensure North Carolina’s hospitals can meet current and future health care needs for the state’s growing population.  
• North Carolina general acute care hospitals reported $5.79 billion in foregone revenue due to uncompensated care. 

The economic impact was measured by calculating the business transactions of all industries within a hospital’s service area and the state. It also measured the hospital and employee spending while calculating the number of jobs and income created through healthcare positions. By using an input output model, IMPLAN, and 2020 data for 137 facilities from the Healthcare Cost Report Information System, RTI determined that health systems and hospitals spent approximately $31 billion in 2020 on staff and operating expenses and an additional $3 billion on new healthcare facility construction. The full report along with regional summary data and an interactive map can be found at NCHA.org/Economic-Impact. 

Critical to Communities: Some Hospital Services and Jobs Could be at Risk 

As hospitals and health systems continue their role as economic flagships in communities and are responding to a respiratory virus “tripledemic,” many of them are struggling to stay in the black. A report by consulting firm Kaufman Hall in September found that 53 percent of all U.S. hospitals expected to lose money in 2022. Some could face tough choices soon, such as whether to reduce services, seek partners, or close. Those decisions could have regional impacts on access to prompt health care, outpatient- and community-based services, obstetric and pediatric care lines and behavioral health services, among others, and could cause both direct and ripple effects on jobs. 

“The economic impact numbers in the report are impressive and yet show only part of the significant value that hospitals and health systems deliver to their communities and the state,” Lawler said. “For example, North Carolina’s hospitals and universities with affiliated medical schools attract millions in federal research funds and educate tomorrow’s health care professionals. I encourage state and local elected officials to visit hospitals in their communities to learn more about their scope of services, regional economic impact, current headwinds and future plans. My hope is that this study will be a springboard to some useful conversations.” 

About NCHA  

Founded in 1918, North Carolina Healthcare Association is the united voice of the North Carolina healthcare community. Representing more than 130 hospitals, health systems, physician groups and other healthcare organizations, NCHA works with our members to improve the health of North Carolina communities by advocating for sound public policies and collaborative partnerships and by providing insights, services, support and education to expand access to high quality, efficient, affordable and integrated health care for all North Carolinians.