As Reimbursements Decline, Providers Find it Easier to Go Green

Further, heating a cooling are optimized by timers, better insulation, and the use of natural light, when possible. The clinic saves about $20,000 a year over a conventional building on lighting and HVAC costs. Further, it used recycled materials when possible on other construction needs.

"One of the lessons is it takes a good year to get all the energy options really effective," he says.

Armstrong cautions that the payback comes over time, but it won't take long, given that he estimates 25% annual savings in utility costs over a comparable traditional building. Further, at least in Portland, the clinic qualified for significant business energy tax credits, which are returned to the owners, the physicians, in the form of offsets.

Armstrong knows the annual savings are a drop in the bucket compared to the projected impact of reduced reimbursements, but "they do make a difference."