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2022 Community Investment Report


Mary Becker

Mary Becker

Senior Vice President of Strategic Partnerships and Communications





  • Community Investment
  • Economic Impact


community benefit community investment economic impact report

Missouri hospitals are always essential.

While COVID-19 impacted almost every aspect of health care, one thing remained unchanged — hospitals’ commitment to their patients and their communities.


Missouri hospitals provided billions of dollars in uncompensated care and community benefit in 2022.

Despite the unprecedented challenges faced in 2020, Missouri hospitals provided more than $1.8 billion in uncompensated care and $3.5 billion in total community benefit.

With the sudden onset of COVID-19, Missouri hospitals were forced to quickly — and continuously — adapt as they learned how to navigate the pandemic. In addition to treating COVID-19 patients, hospitals worked diligently to keep their communities safe by implementing screening measures for patients and visitors, establishing drive-through testing sites, expanding telemedicine capabilities, and reallocating their staff to best serve patients.

In 2020, Missouri hospitals provided more than $1 billion in charity care. Charity care is the amount of care provided by hospitals at no cost to individuals who don’t have insurance and/or the ability to pay. Hospitals also incur bad debt. This occurs when patients have unpaid out-of-pocket costs or fail to make agreed-upon payments for care. In 2020, hospitals’ statewide bad debt costs were more than $721 million.

The combination of charity care and bad debt equals more than $1.8 billion in total uncompensated care provided by Missouri hospitals in 2020. When these costs are added to other community-supporting expenses, that equals hospitals’ statewide community benefit. In the same year, Missouri hospitals provided more than $3.5 billion in total community benefit — an increase of nearly $100 million from 2019, and a 16% increase throughout the last decade.


for every $1 in net income, hospitals provided $2.13 in uncompensated care in 2020, an increase from $1.54 in 2019


2022 Community Benefit Total

Even throughout the pandemic surges, hospitals continued to provide lifesaving care unrelated to COVID-19. Missourians still broke bones, gave birth, received chemotherapy and needed surgery. Hospitals’ operating revenue decreased in 2020; however, federal relief helped reduce the losses overall. Nonetheless, the commitment to providing a safety net for care was strong — for every $1 in net income, hospitals provided $2.13 in uncompensated care in 2020, an increase from $1.54 in 2019.


Missouri hospitals strengthen their communities.

Missouri hospitals’ investments in people and infrastructure continue to power local economies.

None of the benefit provided by Missouri hospitals would be possible without a strong workforce. In 2020, Missouri hospitals employed more than 170,000 individuals — a 42% increase throughout a decade — at a payroll and benefit cost of $12 billion. All hospital staff — from nurses to housekeepers, respiratory therapists to cafeteria workers — supported efforts to combat COVID-19 in their communities, and their salaries ripple throughout the community.

Hospitals also invested $1.6 billion in infrastructure and equipment in 2020 — an increase of more than $400 million throughout a decade. Capital investments support local economies by supporting additional employment and economic activity in the communities hospitals serve.

Impact of Federal Relief Funds

Many hospitals received COVID-19 relief payments from the federal government. Despite the benefit provided by these programs, a significant number of Missouri hospitals are operating with negative margins.

Hospitals and COVID-19

Missouri hospitals always will be essential to their communities and will serve a vital role in maintaining and improving health. Hospitals are there for Missourians in times of crisis — whether it’s serving their communities throughout a pandemic, providing a safety net for those without health insurance or caring for those in a time of need. COVID-19 likely will impact health care long term. While some of those impacts remain to be seen, one thing is certain: Strong communities need strong hospitals, throughout the pandemic and beyond.

A printable snapshot of the 2022 Community Investment Report also is available.

Access hospital-specific data at

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