Healthcare Insights

Top 20 hospitals by highest contract labor expenses

U.S. hospitals are increasingly working with contracted labor to keep their facilities staffed and running to provide quality patient care. While provider burnout rises, the healthcare staffing market is also projected to grow 5.6% from 2022 to 2030

The following table lists the hospitals with the highest contract labor expenses according to data from approximately 8,300 U.S. hospitals.

Hospitals with highest total contract labor expenses

Rank Hospital name City State IDN Total contract labor Explore dataset
Fontana Medical Center Fontana CA Kaiser Permanente Southern California $213,615,634  Explore
Oakland Medical Center Oakland CA Kaiser Permanente Northern California $177,783,841  Explore
Los Angeles Medical Center Los Angeles CA Kaiser Permanente Southern California $176,467,843  Explore
Kaiser Permanente Zion Medical Center San Diego CA Kaiser Permanente Southern California $174,459,283  Explore
Roseville Medical Center Roseville CA Kaiser Permanente Northern California $172,668,359  Explore
Santa Clara Medical Center Santa Clara CA Kaiser Permanente Northern California $153,430,493  Explore
AdventHealth Orlando Orlando FL AdventHealth $146,057,508  Explore
South Sacramento Medical Center Sacramento CA Kaiser Permanente Northern California $143,775,838  Explore
Sacramento Medical Center Sacramento CA Kaiser Permanente Northern California $134,590,229  Explore
10 Barnes-Jewish Hospital Saint Louis MO BJC HealthCare $132,804,022  Explore
11 Orange County - Anaheim Medical Center Anaheim CA Kaiser Permanente Southern California $131,985,955  Explore
12 Saint Vincent Hospital Worcester MA Tenet Healthcare $129,965,182  Explore
13 University of New Mexico Hospital Albuquerque NM University of New Mexico Hospitals $127,971,134  Explore
14 Banner - University Medical Center Phoenix Phoenix AZ Banner Health $125,510,049  Explore
15 Banner - University Medical Center Tucson Tucson AZ Banner Health $123,746,900  Explore
16 Downey Medical Center Downey CA Kaiser Permanente Southern California $119,560,649  Explore
17 The Johns Hopkins Hospital Baltimore MD Johns Hopkins Health System $111,415,768  Explore
18 NYC Health and Hospitals - Bellevue New York NY NYC Health and Hospitals $109,790,176  Explore
19 Manteca Medical Center Manteca CA Kaiser Permanente Northern California $107,784,575  Explore
20 OU Health - University of Oklahoma Medical Center Oklahoma City OK OU Health $106,705,908  Explore

Fig. 1 Data is from the Definitive Healthcare HospitalView product. Data accessed November 2022. 

Which hospitals have the highest contract labor expenses? 

In first, Fontana Medical Center in Fontana, California spent more than $200 million. Next, Oakland Medical Center in Oakland, CA spent $177 million on contract labor, and Los Angeles Medical Center in Los Angeles, CA spent $176 million.  

Beyond the top three facilities, eight additional hospitals on our list are part of the IDN, Kaiser Permanente, and are located in California. Kaiser Permanente is one of the largest IDNs in the U.S. 

How much do hospitals spend on contract labor each year? 

Analyzing financial data from our HospitalView product reveals that the average hospital contract labor spending more than doubled between 2011 and 2020, from $2.23 million to $4.59 million. Hospital spending in 2022 ranges from a few thousand dollars a year to more than $210 million. The average total contract labor expense among the top 20 hospitals is $141 million. 

What is contract labor? 

Contract labor refers to the hiring of independent contractors. Usually, the hiring organization and the independent contractor must complete a labor agreement contract prior to the start of work. 

Employee vs independent contractor 

Independent contractors provide their services on a temporary basis and are not hired as full-time employees. Independent contractors within the healthcare industry can help fill in gaps in staffing, thus supporting healthcare organizations’ ability to care for their patient population. 

Learn more 

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