Owensboro Health leaders say proposed changes at the federal and state levels could have a significant financial impact on the regional health system, with early projections estimating impacts of up to $50 million annually.
During a presentation to local officials, OH President and CEO Mark Marsh said the uncertainty surrounding healthcare policy — particularly related to Medicaid and other federal programs — is one of the biggest challenges facing the organization.
“I hate to use the word uncertainty, but none of us know exactly what’s going to happen in healthcare,” Marsh said. “We know what’s being presented … but we don’t know the full impact.”
Marsh said Owensboro Health is working to prepare for those changes while maintaining care and services across the region.
Owensboro Health, which employs more than 5,000 team members across the many counties it serves, relies heavily on government-funded healthcare programs. Marsh said approximately 75% of the system’s business comes from Medicare and Medicaid.
Because of that reliance, even modest policy changes can have outsized effects locally. Marsh said projections tied to federal legislation and funding shifts could total roughly $50 million per year for Owensboro Health, with long-term impacts projected to approach $1 billion over time.
“At an annual basis, $50 million a year — it’s a big, big, big number,” Marsh said. “There’s a lot that goes into that… this is meaningful.”
At the same time, Marsh said the cost of delivering care continues to climb sharply.
“Before COVID, it cost us about $1.8 million a day,” he said. “Today it’s $2.6 million.”
He attributed that increase to higher labor costs, rising drug prices, and broader inflation across the healthcare industry.
“That’s not unique. That’s throughout the country,” Marsh said.
Despite those pressures, demand for services continues to grow. Emergency room visits are approaching 100,000 annually, while primary care access has expanded significantly in recent years.
“We’ve had 183,000 primary care visits,” Marsh said. “We’ve grown by 36,000 visits.”
He said that expansion is intentional, aimed at helping patients receive preventative care locally rather than relying on emergency services.
Even amid uncertainty, Owensboro Health continues to grow its workforce and provider base.
The system added 30 new physicians in 2025 and 66 over the past three years, bringing its total to nearly 400 providers.
“For every physician you bring into a community… that’s about $3.1 million of annual impact,” Marsh said. “And roughly 15 direct or indirect jobs.”
Overall, the organization accounts for more than $523 million in annual salaries, making it one of the region’s largest economic drivers.
Marsh emphasized that Owensboro Health is continuing to invest in both healthcare access and broader community needs.
Among upcoming initiatives is a new mobile mammography unit, expected to launch this year and serve rural communities across Western Kentucky.
“We’ll be able to do those screenings for folks who maybe wouldn’t be able to receive those in more rural parts of the state,” he said.
The organization is also focusing on what Marsh described as key “social determinants of health,” including mental health, housing, and food access.
Recent efforts include partnering with Habitat for Humanity to create 17 housing lots and organizing a food drive that collected 26,000 pounds of food. Owensboro Health also distributes more than $500,000 annually through community grants to local nonprofits.
While Marsh acknowledged the challenges ahead, he said Owensboro Health remains in a relatively strong financial position compared to some peer systems. Still, he emphasized that the organization is closely monitoring cash flow, costs, and long-term sustainability.
“We have to be very diligent in our decisions,” Marsh said.
Looking ahead, he said the system is focusing on four key areas: revenue growth, cost containment, partnerships, and strategic investment.
“The way healthcare looks today… I feel certain that in 5 or 10 years from now, it will be different,” Marsh said.
Despite that uncertainty, Marsh said the organization remains committed to its role in the community.
“We want to make sure that this is your hospital. This is a community hospital,” he said. “It’s friends and families taking care of friends and families.”
