Home / US Hospital Stats / Comprehensive Hospital Statistics in Pennsylvania, USA

US Hospital Stats

Comprehensive Hospital Statistics in Pennsylvania, USA

March 13, 2026

Pennsylvania operates one of the largest and most complex hospital systems in the United States, with over 180 licensed hospitals, more than 100 health systems, and a hospital industry generating nearly $70 billion in annual revenue. The sector spans major academic medical centers, community hospitals, rural critical access facilities, and ambulatory surgery centers, serving a population of approximately 13 million residents across 67 counties.

This report compiles statistical data on Pennsylvania’s hospitals from multiple authoritative sources, covering the period from 2019 through projected 2026 figures. It tracks hospital supply, financial performance, patient utilization, clinical outcomes, workforce conditions, rural access challenges, Medicaid risk exposure, and price transparency compliance — providing a data-driven picture of the state’s hospital sector as it navigates post-pandemic recovery, consolidation pressures, and evolving public policy.

The data reveals a sector in transition: financially improving in aggregate but deeply uneven in recovery, with rural hospitals, safety-net facilities, and Medicaid-dependent institutions continuing to operate under severe strain. Access gaps — particularly in maternal care, behavioral health, and emergency services — remain acute across rural Pennsylvania, even as major urban and suburban systems report strengthening margins.

Hospital Count, Types, and Infrastructure

Number of Hospitals by Ownership Type (2020–2024)

Non-profit hospitals consistently make up the large majority of Pennsylvania’s hospital base. The table tracks ownership composition from 2020 through 2024, showing a gradual overall decline driven by reductions in for-profit and, since 2022, non-profit facilities.

Year	State/Local Gov.	Non-Profit	For-Profit	Total
2024	2	143	36	181
2023	2	145	36	183
2022	2	146	37	185
2021	2	144	39	185
2020	1	145	40	186

Non-profits accounted for ~79% of all Pennsylvania hospitals across all five years. For-profit hospitals fell from 40 (2020) to 36 (2024).

Hospital Capacity and Population Ratios (2019)

In 2019, Pennsylvania had 371 hospital establishments serving a population of nearly 12.8 million. The figures below describe the state’s hospital density and staffing intensity at that time.

Hospital establishments (Q3 2019): 371
Population (July 1, 2019): 12,801,989
People per hospital: 34,507
Hospital employees (September 2019): 290,922
People per hospital employee: 44

Pennsylvania’s ratio of 34,507 people per hospital exceeded the national average of 23,540, indicating lower hospital density. In staffing, the state performed better — 44 residents per hospital employee versus the national average of 50.

Hospital Industry Size and Growth (Projected 2026)

Industry projections through 2026 show continued growth in market size, business count, and employment, with employment expanding faster than the number of facilities — a sign of ongoing consolidation.

Metric	2026 Projected Value	Avg. Annual Growth (2021–2026)
Market size	$69.9 billion	+1.3%
Number of hospital businesses	253	+0.7%
Number of employees	297,240	+2.0%

Hospital Types — Southeastern Pennsylvania Region

The Southeastern Pennsylvania region, with 72 hospitals, is the state’s most concentrated. Its facility type breakdown illustrates the diversity of care settings found across Pennsylvania.

Hospital Type	Count in SE Penn Region
General Acute Care	42
Psychiatric	12
Rehabilitation	6
Other Specialty	4
Alcoholism / Drug Abuse	3
Long-Term Acute Care	3
Eye	1
Surgical Center	1
Total	72

Hospital Characteristics — Southeastern Pennsylvania Region

Beyond facility type, SE Penn hospitals are notable for their concentration of teaching, trauma, and specialty capabilities. The list below summarizes key characteristics of all 72 hospitals in the region.

Total hospitals in region: 72
Non-profit hospitals: 51
State Tobacco Fund recipients: 32
Teaching hospitals: 30
NICU units: 21
OB/GYN units: 20
340B Program participants: 16
Trauma centers: 14
Burn hospitals: 4
Total staffed beds: 12,011
Total employees in region: 80,740
Federal research funding: $1.15 billion

The SE Penn region alone accounts for 30 teaching hospitals, 14 trauma centers, and over $1 billion in federal research funding — making it the state’s primary academic medicine hub.

Rural Hospital Access

Pennsylvania has 235 active hospitals across all 67 counties, but significant access gaps persist. The figures below describe the rural hospital landscape and current federal investment aimed at addressing it.

Active hospitals statewide: 235
Critical Access Hospitals: 17
Rural-designated hospitals: 34
Total licensed beds (rural hospitals): 45,263
Counties with no hospital access: 9 (13% of all counties)
Birthing hospitals in PA Perinatal Quality Collaborative network: 67 (85.93% of live births)
CMS Rural Health Transformation Program — annual federal funding to PA: $193.3 million
Total federal rural health funding FY2026–2030: $966.5 million

Nine county-level hospital deserts persist despite federal investment of nearly $1 billion earmarked for rural health infrastructure over five years.

Hospital Systems and Consolidation

Community Health and Hospital Systems by Metro Area

Pennsylvania has 104 community health and hospital systems combined employing 205,388 people, earning over $48 billion in annual revenue, and holding $57 billion in assets. The table breaks down the sector by major metropolitan area.

Metro Area	Nonprofit Systems	Employees	Annual Revenue	Assets
Pittsburgh	35	126,359	$33.7 billion	$30.2 billion
Philadelphia	29	24,209	$3.9 billion	$5.9 billion
Harrisburg	6	14,720	$2.9 billion	$3.6 billion
Bloomsburg	2	12,035	$2.7 billion	$6.9 billion
Lancaster	3	9,344	$1.5 billion	$2.7 billion
Reading	1	7,180	$1.4 billion	$1.0 billion
York	4	5,941	$887 million	$774 million
Allentown	3	—	$276 million	$1.6 billion
State College	3	617	$131 million	$54 million
Scranton	2	10	$222 million	$70 million
Altoona	2	24	$58 million	$30 million
Erie	2	24	$1.7 million	$2.1 million
Chambersburg	2	—	$31,277	—
Gettysburg	1	—	$0	—

System Size Distribution

Most Pennsylvania hospital systems are small. The lists below show how 104 systems are distributed by employee count and annual revenue, revealing a highly skewed distribution where a handful of large systems dominate the sector.

By Employment

0 employees (consolidated reporting): 28 systems
1–10 employees: 8 systems
11–25 employees: 6 systems
26–100 employees: 2 systems
101–1,000 employees: 13 systems
Over 1,000 employees: 23 systems

By Annual Revenue

Under $250,000: 18 systems
$250,000 – $1 million: 7 systems
$1 million – $5 million: 5 systems
$5 million – $25 million: 11 systems
$25 million – $100 million: 12 systems
Over $100 million: 30 systems

Systems earning over $100 million annually account for 98.2% of all nonprofit hospital revenue in Pennsylvania; those earning under $1 million account for essentially 0%.

Mergers, Acquisitions, and Closures

Over 90% of all full or partial hospital closures in Pennsylvania in the past 20 years were preceded by a merger, acquisition, or change of ownership. The pace is accelerating, and the window between acquisition and closure is shrinking.

Period	Full/Partial Closures	Preceded by M&A	Avg. Years: M&A to Closure
Past 20 years (2003–2023)	33	30 (91%)	7.6 years
Past 5 years (2018–2023)	15	14 (93%)	4.1 years

Additional Pennsylvania consolidation metrics since 2004:

Hospital mergers and acquisitions: 148
Complete hospital closures: 32
Hospitals that shut down key services only: 25
Share of M&As leading to full or partial closure: 1 in 3
Remaining independent general acute care hospitals (2025): 13
Of those 13, currently slated for acquisition: 2
Hospital closures of major services in 2024: 7
New system buyouts in 2024 (hospitals affected): 4 buyouts / 28 hospitals

Closed Hospitals by Location and Timing — Selected Cases (2003–2023)

The table illustrates the geographic spread of closures and the shortening gap between acquisition and closure across both urban and rural settings.

Hospital	City	County	Setting	Year of M&A	Year of Closure	Years Between
Hahnemann University Hospital	Philadelphia	Philadelphia	Urban	2018	2019	1
UPMC Pinnacle Lancaster Hospital	Lancaster	Lancaster	Urban	2017	2019	2
Elwood City Medical Center	Ellwood City	Lawrence	Rural	2017	2019	2
Mercy Philadelphia	Philadelphia	Philadelphia	Urban	2018	2020	2
UPMC Susquehanna Sunbury	Sunbury	Northumberland	Rural	2017	2020	3
Jennersville Hospital – Tower Health	West Grove	Chester	Urban	2017	2021	4
Brandywine Hospital – Tower Health	Coatesville	Chester	Urban	2017	2022	5
First Hospital – Commonwealth Health	Kingston	Luzerne	Urban	2017	2022	5
Delaware County Memorial Hospital – Crozer Health	Drexel Hill	Delaware	Urban	2016	2022	6
Berwick Hospital Center	Berwick	Columbia	Rural	2020	2022	2
UPMC Lock Haven	Lock Haven	Clinton	Rural	2017	2023	6
Suburban General Hospital	Bellevue	Allegheny	Urban	2004	2010	6
Montgomery Hospital	Norristown	Montgomery	Urban	2005	2012	7
Northeastern Hospital	Philadelphia	Philadelphia	Urban	1995	2009	14

The average time from acquisition to closure has nearly halved — from 7.6 years (20-year average) to 4.1 years (5-year average). With only 13 independent general acute care hospitals remaining, consolidation is reshaping the sector rapidly.

Financial Performance

General Acute Care Hospitals (FY2023 vs. FY2024)

PHC4’s Financial Analysis shows broad improvement in FY2024 statewide metrics, though recovery remained uneven. The table compares key financial indicators year over year, followed by the distribution of margins across hospitals.

Financial Metric	FY2023	FY2024	Change
Net patient revenue	—	$61.0 billion	+9.2%
Total operating revenue	—	$66.6 billion	—
Operating expenses	—	$62.1 billion	—
Operating income	$1.4 billion	$4.5 billion	+$3.1 billion
Average operating margin	2.26%	6.80%	+4.54 pts
Total margin	3.44%	8.34%	+4.90 pts
Uncompensated care (bad debt + charity)	$774 million	$927 million	+19.8%
Uncompensated care as % of net patient revenue	1.38%	1.52%	+0.14 pts
Hospitals with multi-year operating losses	—	39%	—

Distribution of Hospital Margins (FY2024)

While the statewide average improved, a large minority of hospitals remained loss-making or below the sustainability threshold.

Negative (loss)

Operating Margin: 37%
Total Margin: 32%

0%–4% (below sustainability threshold)

Operating Margin: 14%
Total Margin: 10%

Above 4% (healthy)

Operating Margin: 49%
Total Margin: 58%

44% of hospitals with multi-year losses saw their margins worsen further in FY2024. Financial recovery was concentrated among larger, better-resourced institutions.

Rural Hospitals (FY2023 vs. FY2024)

Rural hospital finances improved substantially in FY2024, driven in part by increased Medicaid state-directed payments. The table compares year-over-year changes followed by the margin distribution.

Financial Metric	FY2023	FY2024	Change
Net patient revenue	—	$10.7 billion	+10.1%
Total operating revenue	—	$11.2 billion	—
Operating expenses	—	$10.4 billion	—
Operating income	$254 million	$851 million	Tripled
Average operating margin	2.49%	7.59%	+5.10 pts
Total margin	3.96%	9.79%	+5.83 pts
Uncompensated care	$147 million	$176 million	+19.4%
Uncompensated care as % of net patient revenue	1.52%	1.65%	+0.13 pts

Distribution of Rural Hospital Margins (FY2024)

Margin Category	Operating Margin	Total Margin
Negative (loss)	35%	30%
0%–4%	17%	13%
Above 4%	48%	57%

Rural finances improved more sharply than the statewide average, yet more than a third remain loss-making, and uncompensated care (1.65%) exceeds the statewide acute care average (1.52%).

Ambulatory Surgery Centers (FY2023 vs. FY2024)

There were 287 licensed ASCs in Pennsylvania in FY2024, down from 292. Despite falling patient visit volumes, revenue and margins rose sharply, reflecting a shift toward higher-value procedures and lower overhead costs.

Metric	FY2023	FY2024	Change
Licensed ASCs in Pennsylvania	292	287	−5
ASCs opened during period	—	6	—
ASCs closed during period	—	11	—
Net patient revenue	$1.90 billion	$2.11 billion	+11.1%
Average revenue per outpatient visit	—	$1,602	—
Total outpatient visits	1.39 million	1.32 million	−4.8%
Major outpatient surgical procedures	—	1.0+ million	—
ASC share of all major outpatient surgeries in PA	—	35%	—
Hospital outpatient department share	—	65%	—
Average operating margin	24.31%	29.52%	+5.21 pts
Average total margin	23.63%	29.35%	+5.72 pts

ASC operating margins (29.52%) are more than four times higher than general acute care hospital margins (6.80%), reflecting lower overhead and a more commercially favorable payer mix.

Economic Impact — Southeastern Pennsylvania Hospital Sector (FY2020)

The hospital sector generates substantial economic activity beyond direct patient care. The table captures the direct and ripple effects of SE Penn hospitals on the regional economy, followed by their payer mix.

Total economic output:

Total: $40.7 billion
Direct: $19.2 billion
Ripple: $21.5 billion

Employment supported:

Total: 175,341
Direct: 80,740
Ripple: 94,601

Total salaries:

Total: $12.0 billion
Direct: $6.5 billion
Ripple: $5.5 billion

SE Penn Payor Mix (FY2020 Net Patient Revenue)

The payor mix below shows SE Penn hospitals’ revenue distribution by payer type — significantly more commercially weighted than rural Pennsylvania, where government payers can reach 70% of revenue.

Payor	Share of Net Patient Revenue
Commercial	43%
Medicare	32%
Medicaid	21%
Other	4%

Rural Hospital Economic Contribution (2022)

Rural hospitals are often the single largest employer in their county, generating economic effects far beyond their direct healthcare role. The figures below describe their broader economic contribution.

Total economic output: $14 billion ($8B direct, $6B ripple)
Jobs supported: 69,500+ (39,700 direct, 29,800 ripple)
Total salaries paid: $4.4 billion ($2.9B direct, $1.5B ripple)
Charity care provided: $47+ million
Community health improvement spending: $24+ million
Rural counties where a hospital is a top 10 local employer: 83%

Patient Care and Utilization

Inpatient Utilization by Age Group — Statewide (Q2 2025)

PHC4 tracks inpatient admissions by age group for all Pennsylvania county residents. Patients aged 75 and older form the single largest age cohort, accounting for more than one in four admissions statewide.

Age Group	Total Cases	% of Statewide
Under 18	46,492	12.1%
18–44	78,331	20.4%
45–64	80,713	21.0%
65–74	72,985	19.0%
75 and Older	105,592	27.5%
Statewide Total	384,161	100%

Inpatient Utilization by Age Group — All Counties (Q2 2025)

County-level data reveals significant demographic variation in hospital patient populations. The side-by-side table below shows total inpatient cases and the share of the two most demographically significant age groups — under 18 and 75 and older — for all 67 counties, listed alphabetically.

County	Cases	<18%	75+%
Statewide	384,161	12.1	27.5
Philadelphia	51,396	14.0	16.8
Allegheny	33,921	12.9	25.7
Montgomery	24,620	12.7	30.6
Bucks	17,087	10.4	32.2
Delaware	15,977	13.4	24.7
Berks	14,868	12.1	29.5
Lancaster	13,882	14.0	29.6
York	13,343	12.3	28.4
Westmoreland	12,254	9.0	33.2
Chester	11,901	14.7	29.9
Lehigh	11,870	12.8	28.0
Northampton	11,646	10.0	31.5
Luzerne	10,729	11.1	29.2
Forest	225	10.7	38.2
Bedford	1,406	10.5	37.3

Philadelphia has the lowest 75+ share (16.8%) and the highest 18–44 share (28.2%), reflecting its younger urban population. Forest (38.2%) and Bedford (37.3%) counties have the highest 75+ shares, consistent with older rural demographics.

Major Outpatient Procedures (Calendar Year 2024)

PHC4 tracked 10 commonly performed outpatient procedures. ASCs accounted for 35% of all major outpatient surgical procedures performed in Pennsylvania in 2024, with procedure type determining the split between settings.

Procedure	Total	ASCs	Hospital Outpatient Depts.
Endoscopy – Lower GI Diagnostic	590,176	349,245 (59%)	240,931 (41%)
Endoscopy – Upper GI Diagnostic	295,528	139,758 (47%)	155,770 (53%)
Cataract Procedures	220,531	180,176 (82%)	40,355 (18%)
Carpal Tunnel Release	37,460	21,741 (58%)	15,719 (42%)
Urinary Tract Stone Removal	29,503	4,926 (17%)	24,577 (83%)
Hernia Repair – Groin	23,411	1,981 (8%)	21,430 (92%)
Tonsil and Adenoid Removal	23,193	10,303 (44%)	12,890 (56%)
Gallbladder Removal – Laparoscopic	23,011	266 (1%)	22,745 (99%)
Hernia Repair – Abdomen	18,397	1,366 (7%)	17,031 (93%)
Ear Tube Insertion	21,864	12,440 (57%)	9,424 (43%)

ASCs dominate cataract surgery (82%) and carpal tunnel release (58%). Hospital outpatient departments retain near-total control of complex abdominal procedures: gallbladder removal (99%) and hernia repairs (92–93%).

Preventable Hospital Stays per 100,000 Population (Ages 65+, 2022)

Preventable hospitalization rates among residents aged 65+ indicate the effectiveness of primary and ambulatory care. Pennsylvania’s statewide rate of 2,953 per 100,000 exceeds the national average of 2,666. All 67 counties are shown side-by-side, ranked from highest to lowest.

County — Rate per 100k

Greene — 5,135
Philadelphia — 4,070
Fayette — 3,624
Berks — 3,496
Lehigh — 3,176
Allegheny — 3,041
Dauphin — 3,014
Pennsylvania — 2,953
Bucks — 2,940
Erie — 2,885
Luzerne — 2,854
Montgomery — 2,824
Delaware — 2,781
Chester — 2,580
York — 2,528
Lancaster — 2,018
Union — 1,941

Greene County’s rate (5,135) is 2.6× the national average and 2.7× the lowest county, Union (1,941). The 3,194-point spread signals deep inequities in primary care access across the state.

Clinical Outcomes

PHC4’s Hospital Performance Report compares statewide mortality and 30-day readmission rates for 17 conditions between FFY2018 and FFY2023, based on discharges from October 1, 2022 through September 30, 2023.

In-Hospital Mortality Rates: Statistically Significant Changes (FFY2018 vs. FFY2023)

Eight of 16 reported conditions showed a statistically significant increase in in-hospital mortality over the five-year period. No condition showed a statistically significant decrease.

Condition	2018	2023	Change
Sepsis	8.7%	10.3%	+1.6 pts
Heart Attack – Medical Management	6.8%	7.6%	+0.8 pts
Blood Clot in Lung	2.6%	3.3%	+0.7 pts
Kidney Failure – Acute	2.2%	2.6%	+0.4 pts
Pneumonia – Infectious	2.2%	2.6%	+0.4 pts
Heart Failure	2.4%	2.7%	+0.3 pts
Diabetes – Medical Management	0.5%	0.8%	+0.3 pts
Abnormal Heartbeat	0.8%	0.9%	+0.1 pts

Sepsis saw the largest deterioration (+1.6 pts). The consistent worsening across all eight conditions with no offsetting improvements is linked to staffing shortages and workforce burnout documented in Section 6.

30-Day Readmission Rates: Statistically Significant Changes (FFY2018 vs. FFY2023)

In contrast to mortality, readmission rates improved for most conditions. Seven conditions showed statistically significant decreases; one increased. This suggests progress in discharge planning and post-acute coordination.

Condition	2018	2023	Direction
Respiratory Failure	23.5%	21.3%	Decrease
Heart Failure	23.2%	21.7%	Decrease
Pneumonia – Aspiration	22.3%	20.3%	Decrease
Diabetes – Medical Management	20.4%	18.9%	Decrease
Chest Pain	13.8%	11.3%	Decrease (largest)
Intestinal Obstruction	13.4%	12.2%	Decrease
Abnormal Heartbeat	13.3%	11.2%	Decrease
Blood Clot in Lung	11.7%	13.0%	Increase

Blood Clot in Lung is the only condition with a significant readmission increase, pointing to ongoing challenges in post-discharge thromboembolic management.

Workforce

Staff Vacancy and Turnover Rates (HAP Survey, December 2022)

A HAP survey of member hospitals in December 2022 found vacancy and turnover rates running two to three times historical averages across all major clinical roles.

Medical Assistants: ~42% vacancy rate
Respiratory Therapists: ~32% vacancy / ~12% turnover
Registered Nurses (RNs): ~31% vacancy / 15% turnover
Medical Technologists / Lab Technicians: ~24% vacancy / ~16% turnover

Staffing shortages were identified by hospital leaders as the single greatest threat to financial stability and patient access in 2022.

Labor Cost Escalation

The pandemic triggered dramatic labor cost increases that persist to the present. The following figures document the scale of wage and agency cost increases across Pennsylvania hospitals.

Labor Cost Metric	Value
Contract RN hourly rate — pre-pandemic	~$70/hour
Contract RN hourly rate — 2021–2022 peak	~$180/hour
Contract labor share of nursing costs — pre-pandemic	Under 15%
Increase in contract labor share of nursing costs	+10–20 percentage points
Increase in agency costs for nursing support staff (2019–2021)	+444%
Year-over-year hourly wage increase above pre-pandemic baseline	10–20%
Annual bonus pay at larger PA health systems	Over $50 million
Hospital employee avg. weekly earnings increase since Feb. 2020	+21.1%
COVID-related labor expenses (first half of 2022)	$293.8 million
Total pandemic expense increases + revenue losses (through H1 2022)	~$7.9 billion

Contract RN rates more than doubled to $180/hour at peak, and agency costs for nursing support staff rose 444% in just two years. Hospital wage increases (+21.1%) substantially outpaced the broader private sector.

Administrative Workforce Growth (1991–2020)

A study using Pennsylvania Department of Health and AHA data tracked administrator growth relative to all other staff categories over three decades, finding administrators growing far faster than clinical staff.

Metric	Change 1991–2020
Average number of administrators per hospital	+102% (raw); +60% adjusted for patient volume
Ratio of administrators to registered nurses	+24%
Ratio of administrators to all nurses	+33%
Ratio of administrators to all hospital staff	+70%

Hospital administrators more than doubled over 30 years. The 70% rise in the administrator-to-all-staff ratio is a significant contributor to the operating cost pressures documented in Section 3.

Rural Hospital Challenges

Maternal Health and Birthing Services

The loss of labor and delivery services from rural hospitals has reached a critical scale in Pennsylvania. The figures below describe the current state of rural obstetric access.

Rural PA hospitals that no longer offer labor and delivery: 60%
Women in rural counties more than 30 min from a birthing hospital: 47%+
Women statewide without a birthing hospital within 30 min: More than 12%
Rural hospitals still offering L&D that report financial losses on it: Most remaining
Rural hospitals nationally that stopped obstetric services (2023): 217 (up from 198)
Rural hospitals nationally that stopped chemotherapy (2023): 353 (up from 311)

Three in five rural Pennsylvania hospitals have eliminated labor and delivery services. For many rural women, the nearest birthing hospital is more than an hour away — a life-threatening gap when obstetric complications arise.

Key Systemic Challenges Identified by Rural Hospital Leaders (2023)

HAP convened rural hospital executives in late 2023. Five interconnected challenge areas emerged as the most pressing threats to rural hospital viability.

Workforce: Recruitment and retention of physicians, APPs, and RNs; high agency staffing costs; competition from non-healthcare employers; lack of affordable childcare for staff.
Post-Acute and Behavioral Health Access: Shortage of long-term care, skilled nursing, and home health beds; inadequate behavioral health capacity; ED patient boarding; 96-hour length-of-stay rule complications.
Reimbursement: Rates below cost of care; Medicare/Medicaid up to 70% of patient mix; 340B program under threat; value-based payment barriers for low-volume facilities.
Regulatory Burden: Antiquated regulations not updated post-COVID; inconsistent state agency interpretation across regions; lack of transparency in regulatory decisions.
Emergency Medical Services: Fragmented, volunteer-dependent EMS system; ambulance crew shortages; transportation gaps for post-acute patient transfers.

These five challenge areas are mutually reinforcing: staffing shortages extend inpatient stays; longer stays worsen financial pressure; financial pressure limits retention investment, which deepens shortages further.

Medicaid Dependency and Financial Risk

Hospitals at Risk from Proposed Federal Medicaid Cuts

A 2025 PHAN report identified 47 Pennsylvania hospitals — 1 in 4 — at moderate to significant financial risk from proposed federal Medicaid funding changes. The figures below describe the scale and composition of that risk.

Hospitals at moderate-to-significant risk: 47 (25% of PA hospitals)
Of those, located in rural communities: 17
Hospitals meeting 5 or more risk criteria: 11
Hospitals meeting 3–4 risk criteria: 28
Estimated Pennsylvanians who could lose Medicaid coverage: ~600,000
Estimated resulting annual increase in uncompensated care: $706 million
Full or partial closures/service reductions in PA (past 25 years): 78 total (26 in rural counties)

Risk Assessment Criteria

PHAN assessed each hospital against eight criteria across two categories — patient population characteristics and financial vulnerability indicators.

Patient Population Criteria

High Medicaid enrollment in the hospital’s county
High proportion of uninsured, Medicaid, or Medicare patients
High proportion of low-income patients eligible for charity care

Financial Vulnerability Criteria

High reliance on supplemental public funds to offset losses
Medicaid is the largest or second-largest payer
Medicaid constitutes more than 20% of total payer mix
Medicaid has a large quantified impact on financial performance
Days cash on hand below 100

An estimated $706 million annual increase in uncompensated care would compound already-rising FY2024 trends. Proposed cuts would fall hardest on rural and low-income communities where Medicaid is a core hospital revenue line.

Price Transparency and Financial Assistance Compliance

Federal rules since 2021 require all hospitals to publish a machine-readable standard charge list and a patient-friendly list of shoppable service prices. State law additionally requires public posting of financial assistance policies. PHAN monitors compliance annually across all 184 general acute care and critical access hospitals in Pennsylvania.

Full Price Transparency Compliance Rate

Compliance with federal price transparency rules has stagnated since peaking at 46% in 2023, despite rules having been in effect for over four years.

Year	Share of Hospitals Fully Compliant
2023	46%
2024	41%
2025	41%

Combined Policy Compliance (2023 Assessment, 172 hospitals)

PHAN assessed compliance with both federal price transparency rules and state financial assistance requirements simultaneously. Only a small fraction of hospitals met both standards.

Compliance Status	% of Hospitals	Count
Price Transparency only	42%	71
Neither policy	31%	54
Financial Assistance only	22%	38
Both policies	5%	9

Missing Transparency Components (Number of Hospitals, of 184 assessed)

The table tracks the number of hospitals missing each required transparency component across all three years. The trend on negotiated rates — the most critical data for insured patients — is worsening each year.

Missing Component	2023	2024	2025
Lacking Negotiated Rates for specific plans	73	81	99
Lacking All Payers and Plans	90	31	25
Lacking Negotiated Minimum	51	50	46
Lacking Negotiated Maximum	49	50	46
Lacking Discounted Cash Price	49	48	41
Lacking Gross Charge	48	41	34
Lacking Codes	48	21	22
Lacking Readable File	39	19	21
Lacking Description of Service	—	27	22
Lacking Shoppable List or Price Estimator Tool	12	20	15

Data File Completeness (2025)

PHAN assessed the approximate completeness of each hospital’s published price data file. Approximately one third of hospitals provide essentially complete data, while another third provide less than half of what is required or no file at all.

Over 90% complete: 36% of hospitals
70–90% complete: 18% of hospitals
50–70% complete: 16% of hospitals
Under 50% complete: 19% of hospitals
No file available: 11% of hospitals

Only 5% of Pennsylvania hospitals comply with both price transparency and financial assistance laws. The share failing to provide negotiated rates for specific plans grew from 73 hospitals in 2023 to 99 in 2025 — worsening each year despite rules being in effect since 2021.

Conclusion

Pennsylvania’s hospital finances improved in 2024: the average operating margin for general acute care hospitals increased from 2.26% to 6.80%, and rural hospital operating income tripled. However, nearly 40% of hospitals still operated at a loss, and 44% of hospitals with multi-year losses saw their financial situation worsen. Uncompensated care rose by almost 20%, partly due to the end of pandemic-era Medicaid protections.

The sector continues to face structural challenges, including increasing consolidation, reduced rural access, closures of obstetric services, workforce shortages two to three times historical norms, and rapidly growing administrative costs. Forty-seven hospitals (about 25% statewide) face moderate to significant financial risk from potential Medicaid cuts, which could leave up to 600,000 people uninsured and add $706 million annually in uncompensated care costs.

Price transparency remains very limited: only 5% of hospitals comply with federal and state requirements, and the number failing to publish basic negotiated insurance rates increased from 73 to 99 hospitals between 2023 and 2025. Overall, the data show a system that remains financially fragile, geographically unequal, and insufficiently transparent, highlighting the need for reforms in reimbursement policy, rural access, workforce development, and regulation.