Average Hospital Energy Costs: 2026 Report
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June 30, 2026
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Healing
The following report was compiled by BSA’s team, who contracted an independent research firm that drew information from publicly available benchmark datasets, peer-reviewed studies, and federal agency surveys published between 2015 and 2024. The analysis aggregates data from the U.S. Energy Information Administration’s Commercial Buildings Energy Consumption Survey (CBECS), the Grumman|Butkus Associates Hospital Energy and Water Benchmarking Survey (GBA, August 2024), the U.S. EPA’s Combined Heat and Power program, ASHRAE climate zone research, and the DOE Better Buildings Initiative.
The dataset covers U.S. inpatient and outpatient healthcare facilities across multiple building types, climate zones, and facility sizes. The purpose of this report is to give hospital facility managers, healthcare executives, architects, and engineers a current, fact-checked reference for understanding average hospital energy costs and the design factors that drive them. The primary dataset is presented in the table below.
Average Hospital Energy Costs by Facility Type
Hospitals are the third-most energy-intensive category of commercial building in the United States. Their combination of 24/7 operations, strict ventilation requirements, and heavy process loads — for example sterilization, medical imaging, and patient services — produces energy demands that far exceed those of most other building types.
As a healthcare design firm focused on healing, learning, and discovery environments, BSA compiled the benchmarks below to establish the national baseline for average hospital energy costs.
The Average Hospital Energy Costs by Facility Type in 2026
| Facility Type | Avg. Energy Cost / Sq Ft / Year | Avg. Energy Intensity (BTU / Sq Ft / Year) | Avg. Annual Electricity Use (kWh / Sq Ft) | Intensity vs. Avg. Commercial Building |
| Inpatient Hospital | $3.76 | 193,300 | 31 | 2.75× higher |
| Specialty Hospital (avg.) | ~$3.10 | ~165,000 | ~25 | ~2.3× higher |
| Outpatient Facility | ~$1.40 | 82,000 | 13 | ~1.2× higher |
| Avg. U.S. Commercial Building | ~$1.36 | ~70,000 | ~11.4 | Baseline |
Specialty hospital row represents an estimated midpoint derived from EIA inpatient/outpatient classification data. Sources: GBA 2023 Hospital Energy and Water Benchmarking Survey; EIA CBECS Healthcare Segment; EPA CHP for Hospitals.
Our researchers identified three key findings from this dataset:
- Inpatient hospitals spend nearly 2.8× more per square foot on energy than the average U.S. commercial building, establishing a structural cost floor that no single operational intervention can fully resolve.
- The gap between inpatient ($3.76/sq ft) and outpatient ($1.40/sq ft) annual energy costs reflects the intensive, around-the-clock demands of inpatient environments, including constant HVAC, ventilation, sterilization cycles, and medical imaging equipment operating simultaneously.
- Across all U.S. healthcare buildings combined, annual energy spending exceeds $10 billion, making energy the single largest operational variable that integrated architectural and engineering design can address at scale.
Hospital Energy Use vs. Cost Divergence from 2010 to 2022
One of the most consequential dynamics in hospital energy management is the widening gap between efficiency gains and actual cost outcomes. While hospitals have reduced energy consumption per square foot over the past 15 years, rising utility prices, particularly electricity rates, have outpaced those savings. The result: hospitals are spending more on energy even as they consume less of it.
The table below, built from GBA annual survey data and supplementary EIA benchmarks, illustrates this divergence from 2010 through the most recently published benchmark year.
| Year | Avg. Total Energy Use (BTU / Sq Ft / Year) | Avg. Total Cost ($ / Sq Ft / Year) | Electricity Cost ($ / Sq Ft) | Gas / Steam Cost ($ / Sq Ft) | Primary Trend Driver |
| 2010 | ~275,000 (est.) | ~$2.50 (est.) | ~$1.60 (est.) | ~$0.90 (est.) | Baseline period |
| 2014 | ~252,000 (est.) | ~$2.75 (est.) | ~$1.90 (est.) | ~$0.85 (est.) | Efficiency gains begin; electricity prices rising |
| 2016 | ~240,000 | $3.02 | ~$2.10 | ~$0.92 | Consumption improving; costs rising |
| 2019 | ~238,000 | $2.99 | ~$2.30 | ~$0.67 | Natural gas prices fall; efficiency continues |
| 2020 | ~236,000 | $3.09 | $2.44 | $0.65 | COVID-19 operational disruptions |
| 2021 | 223,778 | $3.16 | $2.40 | $0.75 | Post-pandemic demand rebound |
| 2022 | ~220,000 | $3.76 | $2.78 | $0.98 | Sharpest cost spike in a decade |
Years 2010 and 2014 are marked (est.) and represent directional trend estimates extrapolated from GBA’s 29-year historical survey data. All other values are published benchmarks. Sources: GBA 2023 Hospital Energy and Water Benchmarking Survey (August 2024); CSE Magazine Hospital Benchmarking Survey (2021); GBA 2021 Hospital Energy and Water Survey.
Our researchers identified three key findings from this dataset:
- Between 2010 and 2022, average hospital energy consumption per square foot fell by approximately 18% — yet average energy costs per square foot rose by more than 50% over the same period. Efficiency improvements, while real and measurable, have not kept pace with utility price inflation.
- The 2022 spike to $3.76/sq ft represents an 18.7% year-over-year increase from 2021, which is the largest single-year cost jump in the GBA survey’s 29-year history. It was driven almost entirely by electricity, with hospitals paying an average of $2.78/sq ft on electricity alone.
- The divergence between consumption, which is trending down, and cost, which is trending up, presents a critical strategic implication: operational efficiency measures alone cannot stabilize hospital energy budgets over time. Long-term cost control requires addressing how buildings are designed and engineered from the ground up, even before a single wall is built.
Hospital Energy End-Use Breakdown by Facility Category
Knowing that hospitals spend more on energy than any other commercial building type is only the starting point. Understanding where that energy goes is what allows engineers and design teams to target interventions with the highest return.
The table below, sourced from EIA’s CBECS Healthcare Segment, shows the percentage of total annual energy attributed to each end use for inpatient hospitals, outpatient facilities, and the average commercial building.
The Hospital Energy End-Use Breakdown by Facility Category in 2026
| End Use | Inpatient Hospital | Outpatient Facility | Avg. Commercial Building |
| Space Heating | 32% | 26% | 26% |
| Ventilation | 15% | ~14% | 11% |
| Water Heating | ~10% | ~3% | ~7% |
| Cooking | ~7% | ~1% | ~3% |
| Cooling | 6% | ~16% | ~9% |
| Lighting | 6% | ~17% | ~17% |
| Medical Equipment & Other | ~24% | ~23% | ~27% |
Sources: EIA CBECS Healthcare Buildings Segment (2018); R-Zero, “Understanding Hospital Energy Usage” (2024); E-Source Business Energy Advisor — Hospitals.
Our researchers identified three key findings from this dataset:
- Space heating alone accounts for 32% of inpatient hospital energy use, making building envelope performance, window design, thermal mass, and HVAC configuration the single most impactful set of design variables for long-term energy cost reduction.
- Inpatient hospitals spend 15% of their total energy on ventilation, versus 11% for the average commercial building. Because hospitals already consume 2.75× more energy overall, this translates to an effective ventilation load roughly 3.75× greater than a typical commercial facility.
- Inpatient hospitals spend just 6% of their energy on lighting, which is far below the 17% typical for commercial buildings and outpatient facilities. This means LED upgrades, while valuable, produce limited budget impact in inpatient settings.
Average Hospital Energy Use Intensity by U.S. Climate Zone
Average hospital energy costs are not uniform across the country. Climate zone significantly influences total energy demand and how that demand is distributed between heating, cooling, and ventilation systems.
The table below is based on ASHRAE climate zone classifications and peer-reviewed analysis published in Energies (MDPI, 2019), making it one of the most granular publicly available benchmarks for hospital energy use intensity by U.S. geography.
The Average Hospital Energy Use Intensity by U.S. Climate Zone in 2026
| ASHRAE Climate Zone | Zone Description | Representative Cities | Avg. EUI (kWh / m² / Year) | Avg. EUI (kBTU / Sq Ft / Year) | Dominant Energy Driver |
| Zone 1 (Very Cold) | Subarctic / Cold | Duluth, MN; Minneapolis, MN | 781.1 | ~248 | Space heating |
| Zone 2 (Cold) | Cold-Humid | Chicago, IL; Boston, MA | ~745 | ~236 | Space heating + ventilation |
| Zone 3 (Mixed-Cold) | Mixed-Humid / Marine | Seattle, WA; Baltimore, MD | ~720 | ~228 | Balanced heating / ventilation |
| Zone 4 (Mixed) | Mixed-Dry / Mixed-Humid | Atlanta, GA; Albuquerque, NM | ~700 | ~222 | Balanced heating / cooling |
| Zone 5 (Very Hot) | Hot-Humid / Hot-Dry | Miami, FL; Phoenix, AZ | 640.7 | ~203 | Cooling + ventilation |
| National Average | All Zones | — | ~711 | ~225 | Mixed |
Sources: Zaraket, T., et al. “Energy Consumption Analysis and Characterization of Healthcare Facilities in the United States.” Energies, MDPI (2019); ENERGY STAR DataTrends: Energy Use in Hospitals (EPA, January 2015); ASHE Energy Benchmarking for U.S. Hospitals.
Our researchers identified three key findings from this dataset:
- Hospitals in Zone 1 (Very Cold) use 21.9% more energy per square meter annually than those in Zone 5 (Very Hot) — a gap of 140.4 kWh/m²/year.
- Even in the least energy-intensive climate zone, Zone 5, U.S. hospitals still exceed 640 kWh/m²/year, which is far above the commercial building median.
- Mixed-zone hospitals, especially Zones 3–4, face the most complex design challenge because their facilities must be optimized for both heating-dominated and cooling-dominated seasons simultaneously.
Hospital Energy Savings Potential by Design Strategy
The datasets above confirm that average hospital energy costs are both structurally high and trending upward, driven by utility rates that efficiency improvements alone cannot offset. What they also reveal is that the dominant cost categories, including space heating at 32% and ventilation at 15%, are direct products of decisions made during architecture, engineering, and planning phases.
The table below summarizes documented energy savings achievable through specific integrated design and sustainability strategies, sourced from DOE Better Buildings case studies, ASHRAE design guides, EPA program data, and peer-reviewed research.
The Hospital Energy Savings Potential by Design Strategy in 2026
| Design / Engineering Strategy | Est. Energy Reduction | Primary System Impacted | Approx. Payback Period | Source Basis |
| High-Performance Building Envelope | 10–20% | Space heating / cooling | 5–8 years | DOE Better Buildings Initiative |
| Advanced HVAC + Demand Control Ventilation | 15–25% | Ventilation | 4–7 years | ASHRAE 90.1; NREL |
| LED Lighting + Integrated Daylighting Design | 20–40% | Lighting | 3–5 years | DOE Better Buildings Initiative |
| Combined Heat and Power (CHP) Systems | 8–25% | Heating + electricity | 5–10 years | U.S. EPA CHP Program |
| LEED / ASHRAE 90.1 Certified Design | 20–30% | All systems | Variable | ASHRAE Advanced Energy Design Guide |
| Whole-Building Integrated A/E/P Design | 30–80% | All systems | 7–15 years | ScienceDirect; DOE |
Sources: DOE Better Buildings Initiative — Healthcare Sector; NREL Advanced Energy Retrofit Guide: Healthcare Facilities (2013); EPA CHP for Hospitals; ScienceDirect, “Sustainable, green, or smart? Pathways for energy-efficient healthcare facilities” (2023); PMC/NIH, “Interventions for increasing energy efficiency in hospitals” (2024).
Our researchers identified three key findings from this dataset:
- Whole-building integrated design, that is coordinating architecture, mechanical engineering, structural planning, and interior design under one delivery model, consistently produces the widest efficiency range in published literature: 30–80%.
- Advanced HVAC with demand control ventilation offers one of the strongest returns relative to system impact weight, targeting the ventilation load that accounts for 15% of inpatient energy use.
- Based on the national average of $3.76/sq ft and a 300,000 sq ft inpatient facility, a 30% whole-building efficiency gain through integrated A/E/P design translates to approximately $338,400 in annual energy savings.
Requesting a Copy of This Report
Average hospital energy costs in the United States have reached a structural inflection point. Inpatient facilities now spend an average of $3.76 per square foot annually on energy, and the steepest single-year spike in benchmark history, 18.7% in 2022 alone, demonstrated that operational adjustments cannot fully absorb the volatility of utility markets.
As the data in this report illustrates, the most resilient cost-reduction strategy available to healthcare organizations is one that begins at the design table: integrating architecture, engineering, planning, and sustainability into a coordinated whole.
BSA is a national, award-winning architecture, engineering, interior design, and planning firm. With studios across the country and decades of experience in healthcare, higher education, and research environments, BSA delivers evidence-based, integrated design that treats energy performance as a first-order outcome, not an afterthought.
Our multidisciplinary teams include architects, mechanical and structural engineers, planners, interior designers, and commissioning specialists who work together from pre-design through construction administration.
If you’d like to request a PDF copy of this report or learn more about how BSA approaches energy-conscious healthcare design, you can reach out here.
Sources
- Grumman|Butkus Associates. “2023 Hospital Energy and Water Benchmarking Survey: Combined Calendar Year 2021 and 2022 Data.” Evanston, IL. August 2024. https://grummanbutkus.com/wp-content/uploads/2024/08/2023-HES-Summary-Report-FINAL-public.pdf
- U.S. Energy Information Administration (EIA). “Commercial Buildings Energy Consumption Survey (CBECS): Health Care Buildings.” Washington, D.C. 2018. https://www.eia.gov/consumption/commercial/pba/health-care.php
- U.S. Environmental Protection Agency. “CHP for Hospitals: Superior Energy for Superior Patient Care.” Washington, D.C. https://www.epa.gov/chp/chp-hospitals-superior-energy-superior-patient-care
- Bawaneh, K., et al. “Energy Consumption Analysis and Characterization of Healthcare Facilities in the United States.” Energies, MDPI. Vol. 12, No. 19. 2019. https://www.mdpi.com/1996-1073/12/19/3775
- U.S. Environmental Protection Agency / ENERGY STAR. “DataTrends: Energy Use in Hospitals.” Washington, D.C. January 2015. https://www.energystar.gov/sites/default/files/tools/DataTrends_Hospital_20150129.pdf
- U.S. Department of Energy. “Better Buildings Initiative: Healthcare Sector.” Washington, D.C. https://betterbuildingssolutioncenter.energy.gov/sectors/healthcare
- Karan, E., et al. “Interventions for Increasing Energy Efficiency in Hospitals.” PMC / National Institutes of Health. 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC10913717/
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