The Expense Problem Has Changed
Labor costs have settled into a predictable 3% to 5% band. Drugs, supplies, and purchased services are now the harder problem to solve, growing faster than labor in nearly every region and at nearly every bed size.
The Structural Shift
For years, labor dominated the hospital expense conversation: staffing shortages, travel nurse premiums, and wage competition. The April 2026 data shows a different landscape. Labor expense growth is holding in a tight band of roughly 3% to 5% year over year, regardless of geography or bed size.
Non-labor and drug expenses show no such consistency. Double-digit increases in several regions and bed size cohorts represent a structural shift in where financial pressure originates, and these categories offer fewer obvious levers for management to pull.
National Growth by Category
Three Signals in the Data
Drug Costs Are the Wild Card
Drug expense growth ranges from a 0.6% decline at critical access hospitals (0-25 beds) to +17% in the West and +13.6% at 200-299 bed facilities. No other category shows this much spread.
Geography Now Matters More
The South shows the most balanced profile, with all five categories growing at a similar pace. The West and Midwest face non-labor and drug acceleration well above the national average, complicating systemwide cost strategy for multi-region operators.
Payer Mix Is Eroding at the Same Time
Bad debt and charity care are rising year over year across every region and bed size. Hospitals are absorbing higher costs while collecting less, which turns manageable expense growth into a material threat.
“Expense growth that might be manageable in a stable reimbursement environment becomes significantly more threatening when the payer mix is eroding at the same time.”
National Year-over-Year Expense Growth
Total expense per calendar day rose 7% nationally. The composition tells the real story: labor grew 4% while non-labor and drug expense each grew 9%, more than double the labor rate.
Growth Multiple vs. Labor
What This Means Operationally
Labor cost discipline, the dominant playbook of 2022 through 2024, is no longer the highest-yield target. A hospital that holds labor to 4% but lets non-labor run at 9% is losing ground where contracting, formulary management, utilization review, and purchased services rationalization now carry more leverage.
Purchased services at +4% nationally masks wide variation: +8.1% at 100-199 bed hospitals versus +1.1% at 500+ bed systems, suggesting scale still confers negotiating power in that category.
Expense Growth by Region
The West leads every major category, with drug expense up 17% and non-labor up 13%. The South is the only region where labor and non-labor grew at the same rate.
Regional Expense Profiles
Region Report Cards
Expense Growth by Hospital Bed Size
Total expense growth ranges from +5.1% at 200-299 bed hospitals to +8.0% at both 100-199 and 300-499 bed facilities. Drug expense shows the most dramatic split: critical access hospitals saw drug costs decline 0.6% while 200-299 bed and 500+ bed facilities absorbed increases above 13%.
The Drug Expense Divide
Reading the Bed Size Data
The near-flat drug expense at 0-25 bed hospitals likely reflects a narrower pharmacy formulary and lower exposure to high-cost specialty and oncology drugs, not superior cost control. Mid-size and large hospitals carrying infusion, oncology, and specialty pharmacy volume are absorbing the steepest drug inflation.
Purchased services tell a scale story in reverse: 100-199 bed hospitals saw +8.1% growth while 500+ bed systems held it to +1.1%, consistent with larger systems’ ability to insource, consolidate vendors, and negotiate from volume.
All 60 Statistics
Complete data tables with heat-coded cells. Deeper red indicates faster expense growth; teal indicates the lowest growth (or decline) in the table. All values are year over year change in expense per calendar day, April 2026 vs. April 2025.
National Trends
By Region
By Hospital Bed Size
Heat Map: Every Cohort, Every Category
Implications for Healthcare Finance Leaders
Rebalance the cost agenda
Labor optimization remains necessary but is no longer sufficient. With labor stable at 3% to 5% and non-labor at 9%+, pharmacy spend management, supply chain contracting, and purchased services rationalization deserve the board-level attention labor received in 2022 and 2023.
Treat drug spend as a strategic risk
With regional drug growth reaching 17% and several bed size cohorts above 13%, formulary governance, biosimilar adoption, 340B optimization where applicable, and site-of-care strategy for infusion services move from tactical to strategic.
Localize cost strategy by region
A single systemwide expense target is poorly suited to a market where the West faces 13% non-labor growth and the South faces 6%. Multi-region systems should set region-specific expense benchmarks and escalation triggers.
Model expense growth against payer mix erosion
Rising bad debt and charity care in every region and bed size means margin planning cannot treat expense and revenue assumptions independently. Stress-test budgets against the combined scenario: 7%+ expense growth with deteriorating collections.
Exploit the purchased services scale gap
The spread between +1.1% (500+ beds) and +8.1% (100-199 beds) in purchased services suggests mid-size hospitals should pursue group purchasing expansion, vendor consolidation, and shared services partnerships to capture scale economics they cannot generate alone.
Watch the ambulatory implication
Hospital drug and supply inflation strengthens the economic case for shifting appropriate imaging, infusion, and procedural volume to lower-cost outpatient settings, a dynamic that independent outpatient operators can quantify in payer and employer conversations.
Source & Methodology
Primary Source
Dyrda, L. (2026, July 2). 60 statistics on hospital expenses in mid-2026. Becker’s Hospital Review. Reporting on Kaufman Hall’s National Hospital Flash Report (April 2026 data), which draws on data from more than 1,300 hospitals gathered by Strata Decision Technology.
Measurement Notes
All statistics represent year over year percentage change in expense per calendar day, comparing April 2026 to April 2025. Five expense categories are tracked: total, labor, non-labor, drug, and purchased services. Cohorts include the national aggregate, five regions (West, Midwest, South, Northeast / Mid-Atlantic, Great Plains), and six bed size groups (0-25, 26-99, 100-199, 200-299, 300-499, and 500+ beds).
Editorial Note on the Source List
The published list contains a numbering irregularity: the item labeled #51 (total expense +8.0%) appears at the end of the 200-299 bed group but by structure and sequence belongs to the 300-499 bed group, which otherwise lacks a total expense figure. This dashboard assigns +8.0% total expense to the 300-499 bed cohort and +5.1% to the 200-299 bed cohort, consistent with the list’s internal ordering.
Prepared By
Kelly Emrick, DHSc, PhD, MBA, BSRT(ARRT)R. Healthcare executive, author, and registered radiologic technologist. This dashboard is an independent educational visualization of publicly reported data and is not affiliated with or endorsed by Becker’s Healthcare, Kaufman Hall, or Strata Decision Technology.