North Dakota hospitals contribute an estimated $4.8 billion a year to the state's economy, according to a recent study by the North Dakota Hospital Association. One of the state’s largest employers, the 42 community hospitals directly employ nearly 22,000 full-time equivalents and support more than 14,000 additional FTEs in other sectors. Among other benefits, the hospitals last year provided more than $274 million in charity care and bad debt on behalf of people who were unable to pay for services rendered, a 22% increase from 2012, the report notes.