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Despite the rapid rate of consolidation in the healthcare market, staffing shortages continue to plague care facilities across the U.S. Because facilities are short-staffed, physicians and care providers are working longer hours, spending less time with patients, and spending more time logging clinical data into electronic health record (EHR) systems. All of these factors are contributing to physician burnout.

Burnout is largely fueled by increased reporting demands and widespread adoption of EHR systems and other technologies, such as telemedicine and patient portals. New technology implementations require user training, pulling staff away from patients and necessitating the hire of locum tenens staff and other contracted labor.

We’ve compiled a list of the top hospitals reporting the greatest spending on contracted labor in 2017, the most recent reporting year available. Of the 25 facilities listed, 19 are part of the Kaiser Permanente Health System. In 2017, Kaiser saw dramatic growth, which could be a contributing factor in labor expenses. With a 10 percent membership increase, the health system likely hired locum tenens staff while holding trainings on policy, reporting standards, and technology for new member facilities.

None of the remaining six facilities were members of the same health system at the time of reporting.

Top 25 Hospitals by Contract Labor Spend

  Hospital Name Contract Labor Spend Number of Discharges Number of Staffed Beds

1.

Mayo Clinic Hospital - Saint Marys Campus (MN)

$196,632,765

55,689

1,186

2.

Kaiser Permanente - Fontana Medical Center (CA)

$131,782,553

31,539

626

3.

Kaiser Permanente - Los Angeles Medical Center (CA)

$131,430,479

23,702

460

4.

Kaiser Permanente - San Leandro Medical Center (CA)

$123,021,408

12,092

206

5.

Kaiser Permanente - Oakland Medical Center (CA)

$122,596,188

20,430

365

6.

Kaiser Permanente - Zion Medical Center (CA)

$120,674,466

24,802

556

7.

Kaiser Permanente Santa Clara Medical Center (CA)

$99,327,714

19,691

327

8.

Kaiser Permanente Roseville Medical Center (CA)

$98,929,695

23,364

336

9.

Kaiser Permanente South Sacramento Medical Center (CA)

$96,226,976

15,945

217

10.

Kaiser Permanente Sacramento Medical Center (CA)

$90,213,568

11,788

287

11.

Kaiser Permanente - Downey Medical Center (CA)

$83,545,614

16,554

352

12.

Kaiser Permanente - Manteca Medical Center (CA)

$66,515,202

11,167

213

13.

The Johns Hopkins Hospital (MD)

$66,273,161

45,086

1,007

14.

Kaiser Permanente San Francisco Medical Center (CA)

$65,339,876

11,973

239

15.

Kaiser Permanente San Jose Medical Center (CA)

$63,000,546

11,446

235

16.

Kaiser Permanente - Baldwin Park Medical Center (CA)

$62,782,808

11,364

257

17.

UPMC Presbyterian (PA)

$60,688,190

51,490

1,181

18.

Kaiser Permanente Walnut Creek Medical Center (CA)

$59,610,746

11,957

233

19.

Kaiser Permanente Vallejo Medical Center (CA)

$55,393,474

8,911

200

20.

Grady Hospital (GA)

$50,184,956

32,252

646

21.

UCHealth University of Colorado Hospital (CO)

$49,926,457

31,207

634

22.

Kaiser Permanente - South Bay Medical Center (CA)

$49,099,932

10,240

293

23.

Kaiser Permanente Santa Rosa Medical Center (CA)

$48,821,923

9,958

173

24.

Kaiser Permanente - West Los Angeles Medical Center (CA)

$47,957,948

8,564

265

25.

Banner - University Medical Center Tucson (AZ)

$47,132,301

21,277

479

Fig 1. Data from Definitive Healthcare based on combined net patient revenue reported by IDN member hospitals from fiscal year 2016, the most recent data available. Number of discharges based on compilation of reports from IDN member hospitals.