Adopting combined heat and power technology for a hospital facility can result in net positive cash flow of $700,000 or more while reducing emissions and making a facility more disaster resilient in the face of climate change, according to a new report from Health Care Without Harm and the Boston Green Ribbon Commission.

The report, Powering the Future of Health Care – Financial and Operational Resilience: A Combined Heat and Power Guide for Massachusetts Hospital Decision Makers, is a primer to help hospital executives weigh combined heat and power (CHP)—or cogeneration—technologies and financial considerations to facilitate informed investment decisions.

"As many Massachusetts hospitals have already seen, combined heat and power systems can make a great deal of sense from a financial and sustainability perspective," said Bill Ravanesi, senior director of HCWH’s Health Care Green Building and Energy Program. "This is the right time and the right sector for CHP. As hospitals prepare for future extreme weather events like Superstorm Sandy, this report can help them consider cogeneration for maintaining essential functions during disasters—while contributing to a healthier environment and reducing operating costs year-round."

During Superstorm Sandy in October 2012, many New York and New Jersey hospitals lost power and needed to send patients to other facilities. A number of hospitals that were able to take in these patients had critical capacity provided by CHP systems, including the Montefiore Medical Center in the Bronx and the South Coast Hospital in Amityville, NY.

"Incorporating combined heat and power into our Spaulding Rehabilitation Hospital in Charlestown helped us achieve our goal of making the facility state-of-the-art in terms of technology, energy efficiency, and climate change preparedness," said John Messervy AIA, director of capital and facility planning at Partners HealthCare. "The cost of system downtime at a hospital goes far beyond financial implications—patients’ lives are at stake, and for us, adopting CHP for greater resilience at our facility was the right thing to do."

"The health care sector is one of the largest contributors to greenhouse gas emissions in Massachusetts, with health care facilities in Boston alone emitting half a million metric tons of CO2 in 2012," said John Cleveland, executive director of the Boston Green Ribbon Commission. "With fuel use efficiency of up to 85 percent—significantly higher than conventional generation—and payback periods as short as four years, CHP systems can help Massachusetts hospitals reduce their greenhouse gas emissions by an average of 18 percent, in addition to lowering their power costs. Many members of the Boston Green Ribbon Commission’s health care working group have already been enjoying the savings that come with CHP and are sharing their experiences with others."

For example, the U.S. Department of Energy has estimated that the 47.5-megawatt CHP system at Boston’s Longwood Medical and Academic Area has reduced total fuel consumption for participating facilities by 24 percent, leading to an estimated greenhouse gas reduction of 117,500 tons of CO2 annually. Without the greenhouse gas savings from the CHP facility, Boston’s community-wide greenhouse gas emissions would be roughly 2 percent higher annually—making it more difficult for Boston to achieve the goals of its Climate Action Plan.

The Massachusetts health care sector is poised to become a national leader in CHP adoption. At least 12 Massachusetts health care facilities currently have CHP systems serving their buildings or campuses, with Longwood’s as the largest. Other notable CHP systems include the 426-kilowatt biomass-fired system at the Cooley Dickinson Memorial Hospital in Northampton and the newly upgraded 17.5-megawatt system at the UMass Medical campus in Worcester.

A model in the report shows that a 1-megawatt CHP system at a nonprofit hospital facility could result in annual net positive cash flow of $700,000 or more for the hospital, taking into account generous utility and Massachusetts state incentives and a bond financing structure.

In addition to technology comparisons and financial models, the report also touches on CHP system siting, development, and interconnection. It includes a section with lessons learned and case studies from Massachusetts health care facilities.

The report, which was prepared for Health Care Without Harm and the Boston Green Ribbon Commission by Meister Consultants Group, Inc., is available at http://www.greenribboncommission.org/chp-guide.

About Health Care Without Harm

Heath Care Without Harm, an international coalition of more than 500 organizations in 53 countries, is working to transform the health care sector, without compromising patient safety or care, so that it is ecologically sustainable and no longer a source of harm to public health and the environment. To learn more about HCWH's work, visit http://www.noharm.org, our YouTube channel at HCwithoutharm, and our Twitter feed at @hcwithoutharm.

About the Boston Green Ribbon Commission

The mission of the Green Ribbon Commission (GRC) is to convene leaders from Boston’s key sectors—business, education, health care, civic society, finance, real estate, professional services, tourism and others—to support the goals of the City of Boston’s Climate Action Plan to reduce greenhouse gas emissions by 25% by 2020. The Commission’s 30+ members participate in sector- and issue-specific working groups to share data and identify best practices in energy efficiency, sustainability, and issues related to climate preparedness. For more information, visit http://greenribboncommission.org, with information on the GRC’s Health Care Working Group at http://www.greenribboncommission.org/health-care. Our Twitter feed is @BosGreenRibbon.