Disaster preparedness in healthcare facilities has historically been a low priority and is often viewed as a chore or unnecessary mandate. Researchers published numerous articles and manuals, and policy makers developed seminars devoted to medical surge capacity building. In January 2001, The Joint Commission made significant improvements to its emergency management accreditation standards that strengthened preparedness in hospitals. A central principle to these standards is the requirement that accredited hospitals have an emergency management committee (EMC). A surge capacity plan must consider all the hazards likely to create a sudden increase in healthcare demands. For many decades, hospitals and other healthcare facilities have included evacuation procedures in their emergency plans, but the emphasis was on a response to fire events. Research is needed to determine international, national, state, and local government priorities for funding hospital disaster preparedness as well as the perspective of the health insurance industry in this regard.