This report describes the Design for Health: Summit for Massachusetts Health Care Decision Makers, which was held in Massachusetts in 2004. The primary goal of the summit was to bring together leading healthcare facility decision makers, discuss the arguments for and evidence supporting “healthy design,” and brainstorm initiatives and implementation strategies to achieve healthier hospitals—healthier for patients, healthier for staff, healthier for the environment and community, and healthier for hospital financial security. Featured Summit speakers presented multiple arguments in favor of greening hospitals including environmental stewardship to avoid harming public health while healing individuals, higher performance to enhance patient outcomes and staff performance, and better business practices to provide long-term resource/operational savings, better capital infusion, and better systems reliability and quality.