Boone Health is facing financial difficulties after its separation from the Missouri Heart Center in May.
For the first half of 2026, the hospital’s earnings before interest, taxes, depreciation and amortization were poor, with negative $5,293,777, according to board documents. In the first half of 2025, the hospital’s earnings were positive $3,665,210.
Boone Health has yet to secure a strategic partner since first announcing the search in June 2025. A strategic partner typically helps hospitals alleviate major expenses.
Christian Basi, spokesperson for Boone Health, said that while financial stability is the goal, the hospital is hopeful that its current community investments will provide necessary security.
“It’s difficult to predict the future,” he said. “But what we do know is that Boone Health is doing everything we can to ensure that we will remain here. We’ve been here for 100 years, and we expect to be here for the next 100 years.”
Hospital expenses, patient costs and authorizations
Since becoming an independent hospital in 2021, Boone Health has struggled with its finances.
In 2023, the Missourian reported that Boone Health suffered a $112 million loss and was forced to lay off staff as part of a cost-reduction plan. This loss was further fueled by the financial burdens created by the COVID-19 pandemic.
Since 2020, hospitals nationwide have faced financial struggles; the American Hospital Association recently reported that total hospital expenses grew by 7.5% in 2025, and that 60% of a hospital’s expenses go toward paying staff.
“There is a ton of wage pressure,” said Dave Dillon, the vice president of public and media relations for the Missouri Hospital Association. “There’s also an absolute need to have those professions remain operational. So every hospital, every day, is trying to figure out how to balance those two main things.”
Additionally, Boone Health previously contracted with Missouri Heart Center for the majority of its cardiology services but separated in May. The hospital is now in an ongoing lawsuit against the organization for violating the terms of the contract.
Board documents revealed that Boone Health has taken on fewer cardiology cases. The hospital took on 1,415 cardiac catheterization labs in the first quarter but only 641 labs in the second quarter.
Basi attributed this to be a more unexpected loss that Boone Health took, calling it a “very rare occurrence.” He maintains that the hospital’s new cardiology department is in “really good shape,” and it expects to have more service providers than it had with Missouri Heart Center.
He also said cardiac catheterization labs have increased, with nearly 700 procedures in September.
Patients forgoing non-emergent and/or elective procedures due to costs has also contributed to Boone Health’s financial burdens, Basi said.
The hospital saw a decrease in admissions from 7,267 admissions in the first half of 2025, compared to 6,800 admissions in the first half of 2026, and a decrease of 641 total surgery cases in that same time period.
Currently, Boone Health sees “heavy volumes” of imaging.
“Once the problem is diagnosed and determined that this may not be a life-threatening situation, there’s a decision being made that’s financial,” Basi said. “That says, ‘well, you know, maybe I can live with that for a little bit longer.’”
Dillon agreed that patient costs have also become an issue.
“When the first reaction from needing something from your health insurer is, ‘I hope they approve it,” he said. “We need a system where that isn’t people’s first reaction.”
Healthcare and insurance costs have risen substantially in the past 25 years. According to a recent study published by the National Library of Medicine, total insurance premium costs increased by 342% while average worker earnings increased by only 119% from 1994 to 2024.
Expanding its community footprint
Despite financial hardships, Boone Health is continuing to invest in the mid-Missouri area.
This summer, Boone Health converted an old fire station into a new ambulance station in south Columbia that stores five ambulances and a utility terrain vehicle. The hospital also opened a clinic in Glasgow, which is around 40 miles northwest of Columbia, and will move into an expanded clinic in Ashland in October.
“We are trying to relieve some of those healthcare deserts,” Basi said. “And those expansions show that Boone is not contracting. Yes, we have some financial challenges, absolutely. Many hospitals across the country are facing the same thing, but we are moving forward.”
Boone Health has also received national recognition for its treatment of staff. Forbes ranked Boone Health as one of the top six hospitals in Missouri and also named it a best employer, and the U.S. News & World Report called Boone Health the No. 1 hospital in mid-Missouri and eighth hospital statewide.
