The Scope of the Climate Crisis

Prioritizing healthcare’s responsibility to act

According to a 2022 report from the House Ways and Means Committee, the U.S. healthcare system is responsible for an estimated 10% of national greenhouse gas (GHG) emissions, which cause extreme weather events and contribute to worse health outcomes.

Healthcare systems across the country are now experiencing the damaging effects of climate-related weather events that are predicted to continue and disrupt operations. These events can have a huge financial impact on healthcare organizations. Environmental advocates indicate that failing to establish the infrastructure to track and reduce health sector greenhouse gas emissions will accelerate the impact of these weather events.

The report also says that efforts to curtail emissions or prepare the country’s healthcare infrastructure for climate change have yet to match the potential consequences. Federal health agencies are beginning to focus on the effects of climate change on hospitals, communities and patients as well as the large role healthcare facilities play in contributing to GHG emissions.

The Centers for Medicare & Medicaid Services (CMS) prioritized healthcare equity and climate change in fall of 2022, including a joint statement that was signed by more than 200 medical journals calling climate change the “greatest threat to global health of the coming century.”

The House Ways and Means Committee suggests that healthcare providers add climate resilience planning to their mandated emergency response preparedness plans.

Many current building codes don’t adequately account for climate change, and hospital infrastructure is typically used for many years. Existing structures should be assessed for climate vulnerabilities, but it becomes a financial burden if capital improvements are needed to help existing structures withstand more severe weather. Since health systems likely won’t be able to afford needed upgrades in the short term, they must ensure that any new construction is climate resilient and then prioritize building improvements first in those areas where they deliver critical care such as in emergency departments or intensive care units.

The “scope” of the issue

During HealthTrust Connect, an event hosted by HealthTrust to bring suppliers and members together to knowledge-share with experts, Libbi Lee, a partner with McKinsey & Co., delivered a keynote address and moderated a live Q&A panel. Joining her for the discussion about future demands for new products and technology and how healthcare providers and suppliers can reduce their climate footprint were: Shay Rankhorn, Partner, FD Energy Solutions; Damian Skelton, VP of Facilities and Construction, Hospital Sisters Health System; and Andy Woommavovah, National Director for Facilities and Construction Services, Trinity Health.

Presenters suggested that a good place for healthcare organizations and suppliers to align on the journey toward net zero is on GHG emissions. Emissions are categorized into three “scopes” that correspond roughly to a company’s level of control. Key emissions considerations for health systems and suppliers include:

Energy demand – Scope 1 & 2 carbon emissions related to energy demand, largely in facilities
Energy supply – Indirect carbon emissions stemming from grid electricity supply
Fugitive emissions – Refrigerants and medical gases
Purchased goods and services – Emissions from upstream supply chain activities (the scope 1 & 2 of suppliers)
Fleet – Vehicle emissions

According to The Environmental Protection Agency, these are the definitions of each scope, along with suggested actions as outlined in Health Care’s Climate Footprint, a resource created by Health Care Without Harm and Arup.

Scope 1: Direct GHG emissions that occur from sources that are controlled or owned by an organization (e.g., emissions associated with fuel combustion in boilers, furnaces, vehicles).
- Suggested action – Take immediate action to reduce healthcare facility emissions.
Scope 2: Indirect GHG emissions associated with the purchase of electricity, steam, heat or cooling.
- Suggested action – Invest in and advocate for the decarbonization of local and national energy systems and the implementation of clean, renewable energy.
Scope 3: The result of activities from assets not owned or controlled by the reporting organization, but that the organization indirectly affects in its value chain. Scope 3 emissions include all sources not within an organization’s scope 1 and 2 boundary. The scope 3 emissions for one organization are the scope 1 and 2 emissions of another organization. Scope 3 emissions, also referred to as value chain emissions, often represent the majority of an organization’s total GHG emissions.
- Suggested action – Set and implement criteria for low-carbon or zero emissions procurement so as to begin to decarbonize the supply chain.

It is critical for healthcare facilities to understand their scope 3 emissions because these emissions make up 82% of the health sector footprint in the U.S. The percentage of scope 3 emissions will vary across facilities and health systems, but scope 3 emissions typically account for the largest portion of total emissions.

The Healthcare Climate Council suggests that healthcare organizations have a distinct leadership opportunity to address climate change by following a three-pillar approach to climate-smart healthcare:

Mitigation: Reduce GHG emissions from operations and implement low-carbon healthcare delivery
Resilience: Prepare facilities for climate impacts and help build community health and climate resilience
Leadership: Use the trusted voice and purchasing power of the sector to support the transition to climate-smart policies and a low-carbon economy

Getting started

Not sure where to start on your hospital’s path to net zero? Kaiser Permanente (KP) recently became the first health system to achieve carbon neutral status in the country and shared its journey in an effort to assist other providers in setting the stage for doing the same. Co-authored by Kaiser Permanente and Health Care Without Harm, The Path to Carbon Neutral: A Guide to Building a Climate-Smart Health Care System, shares lessons learned from KP’s journey, as well as resources developed by Health Care Without Harm. The Health Care Climate Council has also developed a playbook that captures how hospitals are operationalizing climate solutions.

HealthTrust solutions

In addition to the sourcing of energy (natural gas and electricity) in deregulated markets, the HealthTrust Energy team offers a utility bill pay service, which ensures on-time payments and provides valuable utility reporting. The Energy team also works individually with members to discuss energy efficiency initiatives, sustainability and renewables that can further reduce members’ energy costs and/or utilization.

The data collection and organization of emissions data is the first step to baseline and set goals for an organization. HealthTrust has identified several suppliers who offer software solutions that automate data collection, apply the most accurate emissions factors, and deliver the insights members will need to identify sustainability and energy efficiency goals. The two National agreements already in place are KeyGreen Solutions and nZero. Both solutions are highly customizable to specific member needs, and offer differing capabilities. The nZero platform is designed primarily for carbon emissions to aid in Scope 1 and 2 capture and reporting. The Keygreen platform is offered by module and offers data analytics on energy, waste generation, food and beverage purchases essential for making healthy food purchase changes and category purchasing (i.e. analyze green cleaning versus conventional cleaning products).

HealthTrust has a national agreement with Bernard ProStar to provide energy-as-a-service (EaaS) solutions for member facilities. BPS can partner with the HealthTrust Energy team for a collaborative approach that addresses both the supply and demand aspects of utilities. While BPS focuses on demand, the HealthTrust Energy team looks at the supply side and how a facility purchases its utilities, how it hedges risk and manages the utilities.

Learn more by contacting your HealthTrust Account Manager.