In energy and real estate, climate risk is now priced. Insurers have pulled out of entire states. Mortgage lenders are factoring flood maps into underwriting. Utility companies are spending billions hardening grid infrastructure against extreme weather. The damage is visible, the cost is measurable, and the market has responded with urgency.

Healthcare hasn't had that reckoning yet. But it's coming, and the gap between where the industry is today and where it will need to be is one of the most significant unaddressed innovation opportunities in the economy.

What we know: the costs are real, and they're already here

When Hurricane Maria struck Puerto Rico in 2017, the official death toll was 64. It took years of research to surface the true number: 2,975 excess deaths according to a George Washington University study, and 4,645 in an initial estimate from a Harvard/NEJM study (later revised to approximately 5,740). Many were not direct storm casualties. They were patients with chronic conditions (heart disease, diabetes, kidney failure) whose care was interrupted when the infrastructure around them failed.

After Hurricane Katrina, patients who missed three or more dialysis sessions had a 2.16x higher chance of hospitalization (Kidney International, 2009). A study of nearly 190,000 dialysis patients across 27 hurricanes found 13% higher mortality associated with storm exposure. In September 2024, Hurricane Helene flooded a single Baxter International facility responsible for ~60% of U.S. IV fluid production, triggering shortages at 86% of U.S. healthcare providers within days.

These costs are real. They surface as excess mortality statistics, insurance claims, supply chain write-offs, and emergency procurement costs, scattered across systems with no shared incentive to add them up. And because no one is measuring the full bill, no one is building the solutions to address it at scale. That's the gap.

What we don't know yet: the full picture is much larger

More than 129 million Americans live with at least one major chronic condition. Among adults 65 and older, it exceeds 90%. These are the patients most exposed to climate disruption, and the ones whose care is most expensive to interrupt. The 2025 Lancet Countdown report found health impacts from climate events worse than ever across 13 of 20 tracked indicators, with heat-related mortality averaging 546,000 deaths globally per year.

In 2024 alone, the U.S. experienced 27 separate billion-dollar climate disasters, according to NOAA. The five-year average cost is $149.3 billion per year. Healthcare absorbs a significant share of that (emergency department surges, medication disruptions, worsened chronic disease management, and preventable hospitalizations) but almost none of it is tracked as climate-related cost. It's just the baseline cost of being a health system.

That's the hidden bill. And it's getting larger every year.

What happens when it comes to light

In real estate, the moment climate risk became measurable and priceable, it changed everything: underwriting models, insurance markets, capital allocation, development decisions. The same dynamic is beginning in healthcare, driven by a combination of payers demanding better outcomes data, health systems facing mounting operational costs from weather disruptions, and regulators starting to ask questions about supply chain concentration and care continuity.

When healthcare prices climate risk the way real estate has, the implications are significant. Health systems will need new models for reaching high-risk patients before and during disasters, not just treating them after. Pharmaceutical and device companies will need distributed supply chains, not concentrated ones. Payers will need predictive tools to identify and intervene with the patient populations most likely to deteriorate when care is disrupted.

None of this infrastructure exists at scale today. That's the opportunity.

The health systems that move first will define the standard

The HHS emPOWER program tracks 4.6 million Medicare beneficiaries who rely on electricity-dependent medical equipment, a starting point for understanding where the exposure sits. But identification is not intervention, and a handful of early movers are already building what comes next.

CVS Health is using environmental data analytics alongside patient medical records to send heat and air quality alerts to at-risk patients up to a week in advance. Mass General Brigham is developing a warning system with IBM to alert vulnerable patients before conditions become emergencies. AstraZeneca partnered with BreezoMeter (since acquired by Google) to pull real-time air quality data into patient care and research.

These are early signals, not a system. The organizations that lead on this will build new capabilities: proactive outreach models for at-risk populations, redundant supply chains, community-based care delivery that functions when physical infrastructure fails.

At Alloy Partners, we've built healthcare ventures that start from this premise: the existing system was not designed for the pressures it now faces. Marti Health extends proactive care coordination to high-risk chronic disease populations. vflok rebuilt workforce scheduling to reduce operational strain before it becomes a crisis. Both were built by co-creating with health system partners who had the clinical depth, the patient relationships, and the infrastructure to give a new venture real advantage from day one. That's what we call an advantaged startup: a company designed from day one with structural advantages no typical startup can replicate.

The energy industry didn't wait for a regulator to tell it to price climate risk. The organizations that treat this as a strategic opportunity, not a compliance obligation, will be the ones that shape what resilient healthcare looks like for the next generation. If you're a healthcare leader thinking about how to get ahead of this, let's talk.a