Hospital water and sewer use is gradually declining, now averaging about 48 gallons per square foot per year, compared with nearly 70 gallons per square foot a decade ago. But that doesn’t mean hospitals are saving as much money as they are water: prices are rising, now averaging 42 cents per square foot versus 24 cents as recently as 2007, indicates a new report from Grumman/Butkus Associates.

And water and sewer costs are expected to rise, the energy efficiency consulting and sustainable design firm says. Price hikes not only reflect increasing costs to extract and treat the water, but also the fact that cash-strapped governmental entities may view water as a revenue source.

The 2017 Hospital Energy and Water Benchmarking Survey also found that hospitals are using less fossil fuel but electricity use isn’t declining as much. The average combined Btu/ft² (electricity plus gas/steam) for participating facilities was 236,910 2016, down slightly from 2015 (237,998 Btu/ft²).

Square-foot prices for gas/steam were down significantly year-to-year ($0.71 in 2016, compared with $0.82 in 2015), and square-foot prices for electricity fell slightly ($2.25 in 2016, vs. $2.28 in 2015). The overall result is that hospitals’ total ft² costs for energy (gas/steam plus electric) declined: $3.02 for 2016, compared with $3.11 for 2015.

The average carbon footprint for hospitals has remained fairly steady at about 60 pounds of CO2 equivalent per ft² per year since the firm began calculating carbon data in 1999. The 2016 stat (about 62 pounds CO2e/ft²/yr) was the highest since 2010. “If we are going to address the very daunting issue of climate change, the healthcare industry must make greater strides in reducing its carbon footprint,” says Dan Doyle, Grumman/Butkus Associates chairman. “As the trend data shows, not enough progress is being made so far.”

Participating facilities displayed a broad range of usage patterns. For instance, some participants are using more than 200,000 BTU/ft² in fossil fuel annually, compared with a general mid-range of facilities (about 130,000 BTU/ft²/year) and those that used least (less than 100,000 BTU/ft²/year or less). Similarly, a few hospitals consume more than 40 kWh/ft²/year in electricity, compared with a mid-range of about 30 kWh/ft²/year. A few squeaked by with less than 18 kWh/ft².

“Facilities that have high unit costs for energy should view this as an opportunity,” says Doyle. “For example, an energy conservation project that would have a five-year payback at an ‘average’ facility may have a payback of just 2.5 or 3 years at a facility with higher unit costs for energy.”

The survey focuses on resource usage trends and costs for healthcare facilities in calendar year 2016.