HUNTSVILLE, Ala. (WHNT) — Half of Alabama’s hospitals are “operating in the red,” according to a new report from the Alabama Hospital Association (AHA).

Known as The Kaufman Hall Report, the document details a dire situation for Alabama hospitals trying to thrive after the COVID-19 pandemic.

Despite receiving federal assistance and funds throughout the pandemic, hospitals in the state saw depressed margins in 2022 when compared to pre-pandemic levels. In fact, the crisis caused those levels to fall 79 percent — making 2022 the worst-performing year of the pandemic.

“Last year was the worst year financially for hospitals nationwide, but the situation in Alabama is much worse,” said Erik Swanson, senior vice president of data and analytics with Kaufman Hall. “The report clearly shows that Alabama’s hospitals are in serious financial difficulty which creates a huge threat to the ability of Alabamians to have access to healthcare.”

Last year alone, Alabama hospitals lost $1.5 billion when compared to 2019. Without federal funds, that total could’ve been much higher — around $2.4 billion.

Don Williamson, president of the Alabama Hospital Association, says the report’s findings signal a collision course with disaster for the state.

“We have only a short window to avoid losing access to services or seeing some hospitals close,” Williamson explained. “While the access crisis will be worse in already underserved rural areas, as local hospitals close and patients pursue care in larger centers, many of the financially precarious urban facilities may not have the resources or capacity to absorb the volume.”

“This report should be the canary in the coal mine for our state and national leaders to ensure the system avoids collapse,” he continued.

There’s no relief in sight for Alabama hospitals either. With or without federal funding, hospital expenses rose faster than revenue.

“A collapse of the system would have a ripple effect on the state’s economy as a whole,” said Joseph Marchant, CEO of Bibb Medical Center and chairman of the Alabama Hospital Association. “There is not one area of our state and local economic infrastructure that doesn’t depend on hospitals and other healthcare providers. 

To read the full Kaufman Hall report, visit