5 Myths About Healthcare’s Drive to Reduce Emissions and Why They’re Wrong

Last summer the Biden Administration and the Department of Health and Human Services (HHS) issued a call to all healthcare stakeholders in the nation to commit to tackling the climate crisis through a new initiative and pledge aimed at reducing greenhouse gas emissions across the healthcare sector. This pledge was re-opened just a few months ago and calls on organizations to agree to cut their greenhouse gas emissions by 50 percent by 2030 and achieve net zero emissions by 2050.

The Joint Commission, an accreditor, collaborator and evaluator of healthcare systems, as well as similar organizations, quickly moved to join what became known as the Health Sector Climate Pledge. Together, they pledged to re-evaluate their criteria for hospital systems environmental impact evaluations.

These evolving state codes, accrediting body evaluations, and movement at the federal level have made it clear—healthcare systems and their stakeholders must commit to aggressive reduction in their carbon footprint (the amount of carbon dioxide emitting due to the consumption of fossil fuels).

Some of the most impactful changes organizations can make are at the facilities level, including energy efficient design and upgrades. However, many health systems are behind in facility upgrades compared to other markets, let alone prepared for a ratcheting up of commitments or requirements in carbon neutrality from operational carbon, created during the construction and use of a facility, or embodied carbon, released from demolition and material sourcing.

The challenge is substantial and for many systems these waters have gone uncharted. Like anything that is unknown, myths have built up around what is and isn't possible.

Here's a look at five myths about healthcare's path to carbon reduction and how they’re wrong. (For more on how healthcare design can impact climate change, read here.)

There's a misconception that sustainable design adds costs—a myth that's not just shortsighted, but potentially harmful. While some sustainable design features, such as high-performance equipment, programmable LED lighting, or insulated windows, may result in additional initial cost, most high-performance design strategies are cost neutral. In fact, most high-performance design decisions will provide savings over the lifetime of the equipment or the facility.

For example, high-performance HVAC equipment creates incremental savings, which over the lifetime cost of the equipment negate the upfront expense. Energy-generating solutions such as solar panels and arrays generate energy that can be bought back by the utility company, providing a new revenue resource for systems. By making the right sustainable design choices based on the scope of each project costly future renovations can be avoided or their costs minimized. This is particularly true given the rapid pace of change within code compliance that the industry has today.

Most healthcare systems are non-profits and reliant on their communities for support. In the past, these organizations were not eligible for the tax incentives that other entities receive for sustainable and carbon or energy-use reduction initiatives. But that isn't the case anymore.

The Inflation Reduction Act has changed the regulatory framework around funding high-performance upgrades and sustainable elements and made tax incentives available to non-profit entities like hospital systems for these changes. This allows for new or expanded tax credits for energy-efficient facilities and incentives for solar panels, battery storage, and microgrids, which can be used by hospitals for renewable energy and resilience.

Healthcare systems often think of sustainable design as "pricey, nice-to-have features" that they should avoid in order to be the best stewards of funding. There is a concern that if they spend too much on ensuring a facility is sustainable or reduces emissions, the community will view it as lavish spending.

However, sustainable and high-performance facilities aren't a luxury. In fact, in the long run, they’re the most responsible use of funds to optimize operational and maintenance costs, while having a positive impact on human health and the environment.

Additionally, people want their communities and the organizations and businesses in them to be responsible actors. This includes being environmental stewards. Polling data from global consulting firm McKinsey & Co. has shown overwhelmingly that consumers and community members value environmentally and ethically sustainable goods and services.

This idea is penny-wise and pound-foolish. Healthcare facilities can't afford not to be ahead of energy codes and standards. Healthcare projects have long schedules, and the code keeps moving the goalposts.

Time and again, clients are advised to position themselves ahead of likely code changes. This can be done by paying attention to leading cities and progressive peers in a certain region and making note of the standards being implemented and followed. It can be assumed that those same standards are not far off for health facilities in nearby regions. Additionally, upcoming energy codes and standards are often telegraphed ahead of time and stipulate efficiency and savings.

There's an argument to be made for the goodwill green facilities can generate in the community, but at the end of the day "sustainable" and "high-performance" are interchangeable terms.

An energy-efficient building with high-performing systems will keep the lights on, the water heated, and the equipment running when other buildings fail. Scientists have already predicted a rise in the number of extreme weather events and the environmental impacts to human health across the world.

A high-performance building is resilient as well as efficient. And in the mission-driven environment of healthcare, there's no excuse not to be considering the future and how your facilities will perform in a crisis.

If the healthcare industry is going to meet the HHS’ 2030 and 2050 goals for reducing carbon emissions, it must dispel the myths, dig into its planning and facility challenges, look forward, get creative, and make informed decisions.

Tim Hurvitz is a healthcare market sector leader and associate principal at HED located in San Francisco, CA. He can be reached at [email protected].