Every year acute care hospitals provide vital health services to thousands of people across New Hampshire. Traditionally, acute care hospitals have been thought of as places with only hospital beds and emergency rooms. In response to diverse health care needs and better ways to deliver services, hospitals have adapted and emerged as hospital systems with a variety of health care services in multiple settings (e.g. medical practices, home care, etc.) available under the same system. In addition, hospital systems are a vital component of our economy. This study documents the economic impact of acute care hospital systems to the economy in New Hampshire.