US nonprofit hospitals spent more than $7.8 billion on management consultants between 2009 and 2023, and the hospitals that hired them showed no meaningful change in their finances, operations or quality of care afterwards.
The study was led by Joseph Dov Bruch of the University of Chicago, with Cal Chengqi Fang (University of Chicago), Yan Bo Zeng (Brown University), Avni Parthan (University of Wisconsin-Madison) and Ashvin D. Gandhi (UCLA Anderson School of Management). It was published online in JAMA on May 4, 2026, and appeared in the June 2, 2026 issue.
An average bill of $15.7 million
More than 20% of nonprofit hospitals hired a management consulting firm during the study period. Those that did paid an average of $15.7 million for the services.
The researchers compared 306 hospitals that used a consultant for the first time between 2010 and 2022 with 513 matched hospitals that used none from 2009 to 2023. A stacked difference-in-differences design tracked how each group changed after a contract began.
No measurable payoff
None of the financial measures moved significantly. Net patient revenue changed by -2.22%, operating expenses by -1.07% and days of cash on hand by -8.56%, all within the range of chance. Total margin shifted by -0.19 percentage points and operating margin by 0.15 points.
Operations looked the same too: inpatient length of stay and total inpatient days showed no significant change. On quality of care, measured by 30-day mortality and readmission for heart attack, pneumonia and stroke, the only significant shift was a 1.37 percentage point rise in stroke readmissions, which did not hold up under alternative specifications.
The authors say their results raise questions about the net value nonprofit hospitals get from consulting, and call for a careful look at how widely consultants are used across health care.
Study Details:
- Title: Changes in Nonprofit Hospitals’ Finances, Operations, and Quality of Care After Using Management Consultants
- Authors: Joseph Dov Bruch, Cal Chengqi Fang, Yan Bo Zeng, Avni Parthan, Ashvin D. Gandhi
- Journal: JAMA, Vol. 335, No. 21, pages 1870-1878
- Publication Date: May 4, 2026 (online); June 2, 2026 (issue)
- DOI: 10.1001/jama.2026.5027