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Medical Equipment & Supplies
The Medical Equipment & Supplies industry researches, develops and produces medical, surgical, dental, ophthalmic and veterinary instruments and devices. Hospitals, clinics and laboratories use these products, which range from disposable items to highly specialised equipment. The increased prevalence of diseases associated with unhealthy lifestyles and an ageing population are important factors that may encourage growth in this industry. Emerging markets and the expansion of health insurance may contribute to further growth. However, the extension of government insurance programmes, provider and payer consolidation, and regulatory emphasis on reduced costs in all markets may result in downward pricing pressure.
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Health Care Delivery
The Health Care Delivery industry owns and manages hospitals, clinics and other health care related facilities. Entities provide a range of services, including inpatient and outpatient care, surgery, mental health, rehabilitation and clinical laboratory services. Demand for health care delivery services is driven largely by insurance coverage rates, demographics, illness and injury rates. The industry is characterised by high fixed labour and facilities costs, and an increased regulatory focus on reduced costs of care and improved outcomes. Health care delivery entities also face significant competition for patients and resources from private, non-profit and religious health care systems.
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Relevant Issues for both Industries (13 of 26)

Why are some issues greyed out?

The SASB Standards vary by industry based on the different sustainability-related risks and opportunities within an industry. The issues in grey were not identified during the standard-setting process as the most likely to be useful to investors, so they are not included in the Standard. Over time, as the ISSB continues to receive market feedback, some issues may be added or removed from the Standard. Each company determines which sustainability-related risks and opportunities are relevant to its business. The Standard is designed for the typical company in an industry, but individual companies may choose to report on different sustainability-related risks and opportunities based on their unique business model.

Environment
- GHG Emissions
- Air Quality
- Energy Management
  The category addresses environmental impacts associated with energy consumption. It addresses the company’s management of energy in manufacturing and/or for provision of products and services derived from utility providers (grid energy) not owned or controlled by the company. More specifically, it includes management of energy efficiency and intensity, energy mix, as well as grid reliance. Upstream (e.g., suppliers) and downstream (e.g., product use) energy use is not included in the scope.
- Water & Wastewater Management
- Waste & Hazardous Materials Management
  The category addresses environmental issues associated with hazardous and non-hazardous waste generated by companies. It addresses a company’s management of solid wastes in manufacturing, agriculture, and other industrial processes. It covers treatment, handling, storage, disposal, and regulatory compliance. The category does not cover emissions to air or wastewater nor does it cover waste from end-of-life of products, which are addressed in separate categories.
- Ecological Impacts
Social Capital
- Human Rights & Community Relations
- Customer Privacy
- Data Security
  The category addresses management of risks related to collection, retention, and use of sensitive, confidential, and/or proprietary customer or user data. It includes social issues that may arise from incidents such as data breaches in which personally identifiable information (PII) and other user or customer data may be exposed. It addresses a company’s strategy, policies, and practices related to IT infrastructure, staff training, record keeping, cooperation with law enforcement, and other mechanisms used to ensure security of customer or user data.
- Access & Affordability
  The category addresses a company’s ability to ensure broad access to its products and services, specifically in the context of underserved markets and/or population groups. It includes the management of issues related to universal needs, such as the accessibility and affordability of health care, financial services, utilities, education, and telecommunications.
- Product Quality & Safety
  The category addresses issues involving unintended characteristics of products sold or services provided that may create health or safety risks to end-users. It addresses a company’s ability to offer manufactured products and/or services that meet customer expectations with respect to their health and safety characteristics. It includes, but is not limited to, issues involving liability, management of recalls and market withdrawals, product testing, and chemicals/content/ingredient management in products.
- Customer Welfare
  The category addresses customer welfare concerns over issues including, but not limited to, health and nutrition of foods and beverages, antibiotic use in animal production, and management of controlled substances. The category addresses the company’s ability to provide consumers with manufactured products and services that are aligned with societal expectations. It does not include issues directly related to quality and safety malfunctions of manufactured products and services, but instead addresses qualities inherent to the design and delivery of products and services where customer welfare may be in question. The scope of the category also captures companies’ ability to prevent counterfeit products.
- Selling Practices & Product Labeling
  The category addresses social issues that may arise from a failure to manage the transparency, accuracy, and comprehensibility of marketing statements, advertising, and labeling of products and services. It includes, but is not limited to, advertising standards and regulations, ethical and responsible marketing practices, misleading or deceptive labeling, as well as discriminatory or predatory selling and lending practices. This may include deceptive or aggressive selling practices in which incentive structures for employees could encourage the sale of products or services that are not in the best interest of customers or clients.
Human Capital
- Labour Practices
- Employee Health & Safety
  The category addresses a company’s ability to create and maintain a safe and healthy workplace environment that is free of injuries, fatalities, and illness (both chronic and acute). It is traditionally accomplished through implementing safety management plans, developing training requirements for employees and contractors, and conducting regular audits of their own practices as well as those of their subcontractors. The category further captures how companies ensure physical and mental health of workforce through technology, training, corporate culture, regulatory compliance, monitoring and testing, and personal protective equipment.
- Employee Engagement, Diversity & Inclusion
  The category addresses a company’s ability to ensure that its culture and hiring and promotion practices embrace the building of a diverse and inclusive workforce that reflects the makeup of local talent pools and its customer base. It addresses the issues of discriminatory practices on the bases of race, gender, ethnicity, religion, sexual orientation, and other factors.
Business Model and Innovation
- Product Design & Lifecycle Management
  The category addresses incorporation of environmental, social, and governance (ESG) considerations in characteristics of products and services provided or sold by the company. It includes, but is not limited to, managing the lifecycle impacts of products and services, such as those related to packaging, distribution, use-phase resource intensity, and other environmental and social externalities that may occur during their use-phase or at the end of life. The category captures a company’s ability to address customer and societal demand for more sustainable products and services as well as to meet evolving environmental and social regulation. It does not address direct environmental or social impacts of the company’s operations nor does it address health and safety risks to consumers from product use, which are covered in other categories.
- Business Model Resilience
- Supply Chain Management
  The category addresses management of environmental, social, and governance (ESG) risks within a company’s supply chain. It addresses issues associated with environmental and social externalities created by suppliers through their operational activities. Such issues include, but are not limited to, environmental responsibility, human rights, labour practices, and ethics and corruption. Management may involve screening, selection, monitoring, and engagement with suppliers on their environmental and social impacts. The category does not address the impacts of external factors – such as climate change and other environmental and social factors – on suppliers’ operations and/or on the availability and pricing of key resources, which is covered in a separate category.
- Materials Sourcing & Efficiency
- Physical Impacts of Climate Change
  The category addresses the company’s ability to manage risks and opportunities associated with direct exposure of its owned or controlled assets and operations to actual or potential physical impacts of climate change. It captures environmental and social issues that may arise from operational disruptions due to physical impacts of climate change. It further captures socio-economic issues resulting from companies failing to incorporate climate change consideration in products and services sold, such as insurance policies and mortgages. The category relates to the company’s ability to adapt to increased frequency and severity of extreme weather, shifting climate, sea level risk, and other expected physical impacts of climate change. Management may involve enhancing resiliency of physical assets and/or surrounding infrastructure as well as incorporation of climate change-related considerations into key business activities (e.g., mortgage and insurance underwriting, planning and development of real estate projects).
Leadership and Governance
- Business Ethics
  The category addresses the company’s approach to managing risks and opportunities surrounding ethical conduct of business, including fraud, corruption, bribery and facilitation payments, fiduciary responsibilities, and other behaviour that may have an ethical component. This includes sensitivity to business norms and standards as they shift over time, jurisdiction, and culture. It addresses the company’s ability to provide services that satisfy the highest professional and ethical standards of the industry, which means to avoid conflicts of interest, misrepresentation, bias, and negligence through training employees adequately and implementing policies and procedures to ensure employees provide services free from bias and error.
- Competitive Behaviour
- Management of the Legal & Regulatory Environment
- Critical Incident Risk Management
- Systemic Risk Management

Disclosure Topics

What is the relationship between General Issue Category and Disclosure Topics?

The General Issue Category is an industry-agnostic version of the Disclosure Topics that appear in each SASB Standard. Disclosure topics represent the industry-specific impacts of General Issue Categories. The industry-specific Disclosure Topics ensure each SASB Standard is tailored to the industry, while the General Issue Categories enable comparability across industries. For example, Health & Nutrition is a disclosure topic in the Non-Alcoholic Beverages industry, representing an industry-specific measure of the general issue of Customer Welfare. The issue of Customer Welfare, however, manifests as the Counterfeit Drugs disclosure topic in the Biotechnology & Pharmaceuticals industry.

Medical Equipment & Supplies Remove
Access Standard
- Energy Management
  The category addresses environmental impacts associated with energy consumption. It addresses the company’s management of energy in manufacturing and/or for provision of products and services derived from utility providers (grid energy) not owned or controlled by the company. More specifically, it includes management of energy efficiency and intensity, energy mix, as well as grid reliance. Upstream (e.g., suppliers) and downstream (e.g., product use) energy use is not included in the scope.
  
  None
- Waste & Hazardous Materials Management
  The category addresses environmental issues associated with hazardous and non-hazardous waste generated by companies. It addresses a company’s management of solid wastes in manufacturing, agriculture, and other industrial processes. It covers treatment, handling, storage, disposal, and regulatory compliance. The category does not cover emissions to air or wastewater nor does it cover waste from end-of-life of products, which are addressed in separate categories.
  
  None
- Data Security
  The category addresses management of risks related to collection, retention, and use of sensitive, confidential, and/or proprietary customer or user data. It includes social issues that may arise from incidents such as data breaches in which personally identifiable information (PII) and other user or customer data may be exposed. It addresses a company’s strategy, policies, and practices related to IT infrastructure, staff training, record keeping, cooperation with law enforcement, and other mechanisms used to ensure security of customer or user data.
  
  None
- Access & Affordability
  The category addresses a company’s ability to ensure broad access to its products and services, specifically in the context of underserved markets and/or population groups. It includes the management of issues related to universal needs, such as the accessibility and affordability of health care, financial services, utilities, education, and telecommunications.
  - Affordability & Pricing
    Health care cost containment and health care access regulatory initiatives may place downward pricing pressures on the Medical Equipment & Supplies industry. This pressure may be increased further by consolidation among health care providers and the role of government-sponsored insurance programmes. Entities that ensure fair pricing may limit the negative effects of cost containment as well as benefitting from the potential revenue opportunities associated with expanded access. Entities that successfully balance the risks and opportunities associated with cost containment and improved access to health care may increase their market share among segments of the population that might ordinarily be less likely to seek health care.
- Product Quality & Safety
  The category addresses issues involving unintended characteristics of products sold or services provided that may create health or safety risks to end-users. It addresses a company’s ability to offer manufactured products and/or services that meet customer expectations with respect to their health and safety characteristics. It includes, but is not limited to, issues involving liability, management of recalls and market withdrawals, product testing, and chemicals/content/ingredient management in products.
  - Product Safety
    Information on product safety and side effects may be discovered after controlled clinical trials and approval. In such cases, entities are exposed to the financial implications of recalls and other adverse events, such as unfavourable media coverage, fines or investigations. Issues related to product safety, such as equipment failures, manufacturing defects, design flaws or inadequate disclosure of product-related risks, may result in significant product liability claims. Entities that limit the incidence of recalls, safety concerns and enforcement actions for manufacturing concerns may better protect shareholder value.
- Customer Welfare
  The category addresses customer welfare concerns over issues including, but not limited to, health and nutrition of foods and beverages, antibiotic use in animal production, and management of controlled substances. The category addresses the company’s ability to provide consumers with manufactured products and services that are aligned with societal expectations. It does not include issues directly related to quality and safety malfunctions of manufactured products and services, but instead addresses qualities inherent to the design and delivery of products and services where customer welfare may be in question. The scope of the category also captures companies’ ability to prevent counterfeit products.
  
  None
- Selling Practices & Product Labeling
  The category addresses social issues that may arise from a failure to manage the transparency, accuracy, and comprehensibility of marketing statements, advertising, and labeling of products and services. It includes, but is not limited to, advertising standards and regulations, ethical and responsible marketing practices, misleading or deceptive labeling, as well as discriminatory or predatory selling and lending practices. This may include deceptive or aggressive selling practices in which incentive structures for employees could encourage the sale of products or services that are not in the best interest of customers or clients.
  - Ethical Marketing
    Entities in the Medical Equipment & Supplies industry face legal and regulatory challenges associated with product marketing. Direct-to-consumer advertisements for medical devices and outreach to physicians provide opportunities for entities to increase their market share. However, challenges arise from the potential for marketing off-label uses, which may result in significant fines and settlements. Corporate disclosure of legal and regulatory fines and the codes of ethics that govern marketing activities may allow investors to develop a better understanding of performance in this area.
- Employee Health & Safety
  The category addresses a company’s ability to create and maintain a safe and healthy workplace environment that is free of injuries, fatalities, and illness (both chronic and acute). It is traditionally accomplished through implementing safety management plans, developing training requirements for employees and contractors, and conducting regular audits of their own practices as well as those of their subcontractors. The category further captures how companies ensure physical and mental health of workforce through technology, training, corporate culture, regulatory compliance, monitoring and testing, and personal protective equipment.
  
  None
- Employee Engagement, Diversity & Inclusion
  The category addresses a company’s ability to ensure that its culture and hiring and promotion practices embrace the building of a diverse and inclusive workforce that reflects the makeup of local talent pools and its customer base. It addresses the issues of discriminatory practices on the bases of race, gender, ethnicity, religion, sexual orientation, and other factors.
  
  None
- Product Design & Lifecycle Management
  The category addresses incorporation of environmental, social, and governance (ESG) considerations in characteristics of products and services provided or sold by the company. It includes, but is not limited to, managing the lifecycle impacts of products and services, such as those related to packaging, distribution, use-phase resource intensity, and other environmental and social externalities that may occur during their use-phase or at the end of life. The category captures a company’s ability to address customer and societal demand for more sustainable products and services as well as to meet evolving environmental and social regulation. It does not address direct environmental or social impacts of the company’s operations nor does it address health and safety risks to consumers from product use, which are covered in other categories.
  - Product Design & Lifecycle Management
    Medical equipment and supplies entities face increasing challenges associated with the human and environmental impact of the industry’s products. Entities may face consumer and regulatory pressure to limit the use of material inputs associated with health concerns, while also addressing issues such as the energy efficiency and end-of-life disposal of specific products. Entities that address these concerns while engaging in efforts to enhance product take-back may satisfy consumer demand and reduce future liabilities better.
- Supply Chain Management
  The category addresses management of environmental, social, and governance (ESG) risks within a company’s supply chain. It addresses issues associated with environmental and social externalities created by suppliers through their operational activities. Such issues include, but are not limited to, environmental responsibility, human rights, labour practices, and ethics and corruption. Management may involve screening, selection, monitoring, and engagement with suppliers on their environmental and social impacts. The category does not address the impacts of external factors – such as climate change and other environmental and social factors – on suppliers’ operations and/or on the availability and pricing of key resources, which is covered in a separate category.
  - Supply Chain Management
    Supply chain quality is essential to protecting consumer health and corporate value. Entities that fail to ensure quality and traceability throughout their supply chains may be susceptible to fines, lost revenue and reputational damage. Additionally, entities may need to manage the use of material inputs that are considered scarce. Disclosure of supply chain audit programmes, strategies to ensure traceability and management of critical materials may better inform investors how entities in this industry are protecting shareholder value.
- Physical Impacts of Climate Change
  The category addresses the company’s ability to manage risks and opportunities associated with direct exposure of its owned or controlled assets and operations to actual or potential physical impacts of climate change. It captures environmental and social issues that may arise from operational disruptions due to physical impacts of climate change. It further captures socio-economic issues resulting from companies failing to incorporate climate change consideration in products and services sold, such as insurance policies and mortgages. The category relates to the company’s ability to adapt to increased frequency and severity of extreme weather, shifting climate, sea level risk, and other expected physical impacts of climate change. Management may involve enhancing resiliency of physical assets and/or surrounding infrastructure as well as incorporation of climate change-related considerations into key business activities (e.g., mortgage and insurance underwriting, planning and development of real estate projects).
  
  None
- Business Ethics
  The category addresses the company’s approach to managing risks and opportunities surrounding ethical conduct of business, including fraud, corruption, bribery and facilitation payments, fiduciary responsibilities, and other behaviour that may have an ethical component. This includes sensitivity to business norms and standards as they shift over time, jurisdiction, and culture. It addresses the company’s ability to provide services that satisfy the highest professional and ethical standards of the industry, which means to avoid conflicts of interest, misrepresentation, bias, and negligence through training employees adequately and implementing policies and procedures to ensure employees provide services free from bias and error.
  - Business Ethics
    Entities in the Medical Equipment & Supplies industry are subject to various international, national and local laws pertaining to health care fraud and abuse. An entity’s ability to ensure compliance throughout its global and domestic operational footprint may have notable effects on enterprise viability and reputation. Corporate disclosure of legal and regulatory fines and the codes of ethics that govern interactions with health professionals may better allow investors to monitor performance in this area.
Health Care Delivery Remove
Access Standard
- Energy Management
  The category addresses environmental impacts associated with energy consumption. It addresses the company’s management of energy in manufacturing and/or for provision of products and services derived from utility providers (grid energy) not owned or controlled by the company. More specifically, it includes management of energy efficiency and intensity, energy mix, as well as grid reliance. Upstream (e.g., suppliers) and downstream (e.g., product use) energy use is not included in the scope.
  - Energy Management
    Health Care Delivery entities operate energy-intensive facilities and rely on both purchased electricity and fuel. The consumption of both can contribute to environmental impacts, including climate change and pollution. Legislative attempts to limit these impacts and to incentivise energy efficiency and renewable energy may result in price volatility associated with fossil fuels and conventional electricity. Entities that improve energy efficiency may decrease costs and limit exposure to energy price fluctuations.
- Waste & Hazardous Materials Management
  The category addresses environmental issues associated with hazardous and non-hazardous waste generated by companies. It addresses a company’s management of solid wastes in manufacturing, agriculture, and other industrial processes. It covers treatment, handling, storage, disposal, and regulatory compliance. The category does not cover emissions to air or wastewater nor does it cover waste from end-of-life of products, which are addressed in separate categories.
  - Waste Management
    Health Care Delivery entities generate a significant amount of regulated medical and pharmaceutical waste. Disposal fees for these types of waste are typically higher than that of conventional waste and may present a significant cost for the industry. Entities that reduce the amount of waste generated by enhanced waste segregation strategies, recycling and reuse may limit their exposure to these costs.
- Data Security
  The category addresses management of risks related to collection, retention, and use of sensitive, confidential, and/or proprietary customer or user data. It includes social issues that may arise from incidents such as data breaches in which personally identifiable information (PII) and other user or customer data may be exposed. It addresses a company’s strategy, policies, and practices related to IT infrastructure, staff training, record keeping, cooperation with law enforcement, and other mechanisms used to ensure security of customer or user data.
  - Patient Privacy & Electronic Health Records
    Many jurisdictions require health care providers to establish administrative, physical and technical safeguards to protect the integrity, confidentiality, interoperability and availability of patient health information. Failure to comply with such regulations may result in civil and criminal penalties.
- Access & Affordability
  The category addresses a company’s ability to ensure broad access to its products and services, specifically in the context of underserved markets and/or population groups. It includes the management of issues related to universal needs, such as the accessibility and affordability of health care, financial services, utilities, education, and telecommunications.
  - Access for Low-Income Patients
    Some care delivery entities will continue to face challenges associated with serving uninsured and low-income patients. Health care delivery entities that develop innovative pricing structures that allow them to profit from increased private insurance enrolment and to expand their patient base may create a positive effect on revenue. Disclosure on how entities manage the provision of care to uninsured populations may allow users to understand the associated risks and opportunities.
- Product Quality & Safety
  The category addresses issues involving unintended characteristics of products sold or services provided that may create health or safety risks to end-users. It addresses a company’s ability to offer manufactured products and/or services that meet customer expectations with respect to their health and safety characteristics. It includes, but is not limited to, issues involving liability, management of recalls and market withdrawals, product testing, and chemicals/content/ingredient management in products.
  - Quality of Care & Patient Satisfaction
    Quality care delivery and patient satisfaction are essential value drivers for health care delivery entities. The link between quality of care performance and value creation may be strengthened by effective management focus on improving health care quality measures. In addition, entities may improve health care outcomes and preserve brand value by developing programmes to reduce excessive patient readmission rates and hospital-acquired conditions.
- Customer Welfare
  The category addresses customer welfare concerns over issues including, but not limited to, health and nutrition of foods and beverages, antibiotic use in animal production, and management of controlled substances. The category addresses the company’s ability to provide consumers with manufactured products and services that are aligned with societal expectations. It does not include issues directly related to quality and safety malfunctions of manufactured products and services, but instead addresses qualities inherent to the design and delivery of products and services where customer welfare may be in question. The scope of the category also captures companies’ ability to prevent counterfeit products.
  - Management of Controlled Substances
    The Health Care Delivery industry is in a unique position with respect to the evolving use of controlled substances and managing the risk of addiction. As the provider of care, the industry also treats individuals suffering from addiction and related health concerns. Health Care Delivery entities face significant costs in addressing the health care needs of those suffering from addiction and related illnesses. Industry-wide efforts to re-evaluate controlled substance management strategies through the development of new policies, training and oversight may have positive financial effects.
- Selling Practices & Product Labeling
  The category addresses social issues that may arise from a failure to manage the transparency, accuracy, and comprehensibility of marketing statements, advertising, and labeling of products and services. It includes, but is not limited to, advertising standards and regulations, ethical and responsible marketing practices, misleading or deceptive labeling, as well as discriminatory or predatory selling and lending practices. This may include deceptive or aggressive selling practices in which incentive structures for employees could encourage the sale of products or services that are not in the best interest of customers or clients.
  - Pricing & Billing Transparency
    Concern regarding pricing and billing transparency in the Health Care Delivery industry has resulted in increased legal and regulatory scrutiny in some jurisdictions. Coupled with increased attention to health care cost containment, this scrutiny may increase regulatory oversight of pricing and billing practices in this industry. Entities that achieve compliance and institute transparent pricing structures may better protect shareholder value.
- Employee Health & Safety
  The category addresses a company’s ability to create and maintain a safe and healthy workplace environment that is free of injuries, fatalities, and illness (both chronic and acute). It is traditionally accomplished through implementing safety management plans, developing training requirements for employees and contractors, and conducting regular audits of their own practices as well as those of their subcontractors. The category further captures how companies ensure physical and mental health of workforce through technology, training, corporate culture, regulatory compliance, monitoring and testing, and personal protective equipment.
  - Workforce Health & Safety
    The Health Care Delivery industry is heavily dependent on a skilled workforce, and employees routinely are exposed to injury, illness and infection during regular duties. Relative to other industries, Health Care Delivery has one of the highest rates of injury and illness. Entities that manage this issue more effectively may reduce costs associated with workers’ compensation, productivity, morale and employee retention. Entities often mitigate risks by implementing proactive health and safety management protocols, developing employee training requirements, and conducting regular audits of their own safety practices.
- Employee Engagement, Diversity & Inclusion
  The category addresses a company’s ability to ensure that its culture and hiring and promotion practices embrace the building of a diverse and inclusive workforce that reflects the makeup of local talent pools and its customer base. It addresses the issues of discriminatory practices on the bases of race, gender, ethnicity, religion, sexual orientation, and other factors.
  - Employee Recruitment, Development & Retention
    Health care delivery entities will continue to face increased competition for physicians because of increased demand, which is intensified by current and future shortages. The ability to recruit, develop and retain health care practitioners is critical to success in this industry, and disclosure on related performance indicators allows users to understand how entities are managing this important human capital issue.
- Product Design & Lifecycle Management
  The category addresses incorporation of environmental, social, and governance (ESG) considerations in characteristics of products and services provided or sold by the company. It includes, but is not limited to, managing the lifecycle impacts of products and services, such as those related to packaging, distribution, use-phase resource intensity, and other environmental and social externalities that may occur during their use-phase or at the end of life. The category captures a company’s ability to address customer and societal demand for more sustainable products and services as well as to meet evolving environmental and social regulation. It does not address direct environmental or social impacts of the company’s operations nor does it address health and safety risks to consumers from product use, which are covered in other categories.
  
  None
- Supply Chain Management
  The category addresses management of environmental, social, and governance (ESG) risks within a company’s supply chain. It addresses issues associated with environmental and social externalities created by suppliers through their operational activities. Such issues include, but are not limited to, environmental responsibility, human rights, labour practices, and ethics and corruption. Management may involve screening, selection, monitoring, and engagement with suppliers on their environmental and social impacts. The category does not address the impacts of external factors – such as climate change and other environmental and social factors – on suppliers’ operations and/or on the availability and pricing of key resources, which is covered in a separate category.
  
  None
- Physical Impacts of Climate Change
  The category addresses the company’s ability to manage risks and opportunities associated with direct exposure of its owned or controlled assets and operations to actual or potential physical impacts of climate change. It captures environmental and social issues that may arise from operational disruptions due to physical impacts of climate change. It further captures socio-economic issues resulting from companies failing to incorporate climate change consideration in products and services sold, such as insurance policies and mortgages. The category relates to the company’s ability to adapt to increased frequency and severity of extreme weather, shifting climate, sea level risk, and other expected physical impacts of climate change. Management may involve enhancing resiliency of physical assets and/or surrounding infrastructure as well as incorporation of climate change-related considerations into key business activities (e.g., mortgage and insurance underwriting, planning and development of real estate projects).
  - Climate Change Impacts on Human Health & Infrastructure
    An increase in extreme weather events associated with climate change may present physical threats to health care delivery facilities and create challenges in serving affected populations. Coupled with the potential spread of infectious diseases and food and water scarcity, these events may present material implications for the Health Care Delivery industry.
- Business Ethics
  The category addresses the company’s approach to managing risks and opportunities surrounding ethical conduct of business, including fraud, corruption, bribery and facilitation payments, fiduciary responsibilities, and other behaviour that may have an ethical component. This includes sensitivity to business norms and standards as they shift over time, jurisdiction, and culture. It addresses the company’s ability to provide services that satisfy the highest professional and ethical standards of the industry, which means to avoid conflicts of interest, misrepresentation, bias, and negligence through training employees adequately and implementing policies and procedures to ensure employees provide services free from bias and error.
  - Fraud & Unnecessary Procedures
    Health care delivery entities may be subject to significant fines and penalties if their staff are found to be engaged in medical fraud. Many entities must have written policies for all employees and contractors regarding false claims, false statements and whistle-blower protections. The ability to ensure compliance in this area may have implications for health care delivery entities, including one-time charges and reputational damage.

General Issue Category

Remove Medical Equipment & Supplies Access Standard

Remove Health Care Delivery Access Standard

Energy Management

Energy Management
Health Care Delivery entities operate energy-intensive facilities and rely on both purchased electricity and fuel. The consumption of both can contribute to environmental impacts, including climate change and pollution. Legislative attempts to limit these impacts and to incentivise energy efficiency and renewable energy may result in price volatility associated with fossil fuels and conventional electricity. Entities that improve energy efficiency may decrease costs and limit exposure to energy price fluctuations.

Waste & Hazardous Materials Management

Waste Management
Health Care Delivery entities generate a significant amount of regulated medical and pharmaceutical waste. Disposal fees for these types of waste are typically higher than that of conventional waste and may present a significant cost for the industry. Entities that reduce the amount of waste generated by enhanced waste segregation strategies, recycling and reuse may limit their exposure to these costs.

Data Security

Patient Privacy & Electronic Health Records
Many jurisdictions require health care providers to establish administrative, physical and technical safeguards to protect the integrity, confidentiality, interoperability and availability of patient health information. Failure to comply with such regulations may result in civil and criminal penalties.

Access & Affordability

Affordability & Pricing
Health care cost containment and health care access regulatory initiatives may place downward pricing pressures on the Medical Equipment & Supplies industry. This pressure may be increased further by consolidation among health care providers and the role of government-sponsored insurance programmes. Entities that ensure fair pricing may limit the negative effects of cost containment as well as benefitting from the potential revenue opportunities associated with expanded access. Entities that successfully balance the risks and opportunities associated with cost containment and improved access to health care may increase their market share among segments of the population that might ordinarily be less likely to seek health care.

Access for Low-Income Patients
Some care delivery entities will continue to face challenges associated with serving uninsured and low-income patients. Health care delivery entities that develop innovative pricing structures that allow them to profit from increased private insurance enrolment and to expand their patient base may create a positive effect on revenue. Disclosure on how entities manage the provision of care to uninsured populations may allow users to understand the associated risks and opportunities.

Product Quality & Safety

Product Safety
Information on product safety and side effects may be discovered after controlled clinical trials and approval. In such cases, entities are exposed to the financial implications of recalls and other adverse events, such as unfavourable media coverage, fines or investigations. Issues related to product safety, such as equipment failures, manufacturing defects, design flaws or inadequate disclosure of product-related risks, may result in significant product liability claims. Entities that limit the incidence of recalls, safety concerns and enforcement actions for manufacturing concerns may better protect shareholder value.

Quality of Care & Patient Satisfaction
Quality care delivery and patient satisfaction are essential value drivers for health care delivery entities. The link between quality of care performance and value creation may be strengthened by effective management focus on improving health care quality measures. In addition, entities may improve health care outcomes and preserve brand value by developing programmes to reduce excessive patient readmission rates and hospital-acquired conditions.

Customer Welfare

Management of Controlled Substances
The Health Care Delivery industry is in a unique position with respect to the evolving use of controlled substances and managing the risk of addiction. As the provider of care, the industry also treats individuals suffering from addiction and related health concerns. Health Care Delivery entities face significant costs in addressing the health care needs of those suffering from addiction and related illnesses. Industry-wide efforts to re-evaluate controlled substance management strategies through the development of new policies, training and oversight may have positive financial effects.

Selling Practices & Product Labeling

Ethical Marketing
Entities in the Medical Equipment & Supplies industry face legal and regulatory challenges associated with product marketing. Direct-to-consumer advertisements for medical devices and outreach to physicians provide opportunities for entities to increase their market share. However, challenges arise from the potential for marketing off-label uses, which may result in significant fines and settlements. Corporate disclosure of legal and regulatory fines and the codes of ethics that govern marketing activities may allow investors to develop a better understanding of performance in this area.

Pricing & Billing Transparency
Concern regarding pricing and billing transparency in the Health Care Delivery industry has resulted in increased legal and regulatory scrutiny in some jurisdictions. Coupled with increased attention to health care cost containment, this scrutiny may increase regulatory oversight of pricing and billing practices in this industry. Entities that achieve compliance and institute transparent pricing structures may better protect shareholder value.

Employee Health & Safety

Workforce Health & Safety
The Health Care Delivery industry is heavily dependent on a skilled workforce, and employees routinely are exposed to injury, illness and infection during regular duties. Relative to other industries, Health Care Delivery has one of the highest rates of injury and illness. Entities that manage this issue more effectively may reduce costs associated with workers’ compensation, productivity, morale and employee retention. Entities often mitigate risks by implementing proactive health and safety management protocols, developing employee training requirements, and conducting regular audits of their own safety practices.

Employee Engagement, Diversity & Inclusion

Employee Recruitment, Development & Retention
Health care delivery entities will continue to face increased competition for physicians because of increased demand, which is intensified by current and future shortages. The ability to recruit, develop and retain health care practitioners is critical to success in this industry, and disclosure on related performance indicators allows users to understand how entities are managing this important human capital issue.

Product Design & Lifecycle Management

Product Design & Lifecycle Management
Medical equipment and supplies entities face increasing challenges associated with the human and environmental impact of the industry’s products. Entities may face consumer and regulatory pressure to limit the use of material inputs associated with health concerns, while also addressing issues such as the energy efficiency and end-of-life disposal of specific products. Entities that address these concerns while engaging in efforts to enhance product take-back may satisfy consumer demand and reduce future liabilities better.

Supply Chain Management

Supply Chain Management
Supply chain quality is essential to protecting consumer health and corporate value. Entities that fail to ensure quality and traceability throughout their supply chains may be susceptible to fines, lost revenue and reputational damage. Additionally, entities may need to manage the use of material inputs that are considered scarce. Disclosure of supply chain audit programmes, strategies to ensure traceability and management of critical materials may better inform investors how entities in this industry are protecting shareholder value.

Physical Impacts of Climate Change

Climate Change Impacts on Human Health & Infrastructure
An increase in extreme weather events associated with climate change may present physical threats to health care delivery facilities and create challenges in serving affected populations. Coupled with the potential spread of infectious diseases and food and water scarcity, these events may present material implications for the Health Care Delivery industry.

Business Ethics

Business Ethics
Entities in the Medical Equipment & Supplies industry are subject to various international, national and local laws pertaining to health care fraud and abuse. An entity’s ability to ensure compliance throughout its global and domestic operational footprint may have notable effects on enterprise viability and reputation. Corporate disclosure of legal and regulatory fines and the codes of ethics that govern interactions with health professionals may better allow investors to monitor performance in this area.

Fraud & Unnecessary Procedures
Health care delivery entities may be subject to significant fines and penalties if their staff are found to be engaged in medical fraud. Many entities must have written policies for all employees and contractors regarding false claims, false statements and whistle-blower protections. The ability to ensure compliance in this area may have implications for health care delivery entities, including one-time charges and reputational damage.

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