Many hospitals in Maine, particularly larger ones, are heavily in debt, poor and working out of older facilities, according to a recent report from the Maine Hospital Association.
The Financial Analysis of Maine’s Hospitals 2025, obtained by Becker’s, was conducted by PYA, a healthcare consulting firm, and revealed that Maine hospitals are in a “precarious financial condition.” The report comes amid an increase in maternity service closures across the state. Becker’s has reported on 12 across the U.S. in 2025 so far, with four of the closures taking place in Maine.
Here are six more findings from the report:
1. Maine’s prospective payment system hospitals ranked poorly when compared to hospitals nationally based on 2023 median financial metrics. PPS hospitals performed 39th for total margin, 46th for operating margin and 49th for equity financing ratio, which suggests weak financial stability and profitability. The state’s PPS hospitals saw an improvement in return on equity and occupancy rate metrics, ranking 21st for both.
2. Maine CAH hospitals ranked 29th for total margin nationally, 17th for operating margin and 24th for equity financing ratio. The average age of CAH hospital fixed assets in the state ranked 40th, suggesting aged infrastructures that could result in long-term financial strain and increased maintenance costs.
3. Maine PPS hospital total margins had a median of 0% in 2023, while the U.S. national average was 3%. Operating margin was -12% and return on equity was 7%. “[Maine] struggles with expenses exceeding revenue, relying on non-operating income to break even,” the report said. Maine CAH hospital total margins were a median of 2%, while the U.S. national average was 4%. Operating margin was -4% and return on equity was 5%.
4. The report found that Maine CAH and PPS hospitals have the highest percentage of medium and high-risk hospitals compared to neighboring states New Hampshire and Vermont based on fiscal year 2023 data.
5. Based on a 2025 Chartis Rural Health State of the State Report that identified 432 rural hospitals at risk of closing, no rural Maine hospitals were identified as at risk of closure. “However, this fact alone does not support the conclusion that Maine hospitals do not face financial distress likely to result in decreased services for the communities they serve,” the report said.
6. To ensure improvements, Maine’s CAH and PPS hospitals must ensure “strategic focus on cost control, revenue diversification and operational efficiency” for financial stability, the report said.
