The Hilltop Institute at UMBC is proud to announce the opening of its new Hospital Community Benefit Program. Made possible by the generous support of the Robert Wood Johnson Foundation and the Kresge Foundation, the program will be the first ever central resource created specifically for state and local policymakers to improve the reporting and evaluation of tax-exempt hospitals’ community benefit activities. The Hospital Community Benefit Program will be a resource to state and local health departments, hospital regulators, legislators, revenue collection and budgeting agencies, and hospitals, as each entity works to improve the transparency, comparability, fairness, and effectiveness of the community benefits delivered by tax-exempt hospitals.
New federal health reform legislation, the Affordable Care Act (ACA), is projected to reduce the uninsured by 32 million, reduce the volume of charity care provided by tax-exempt hospitals, and shift the focus and investment of hospitals’ community benefit obligations. These obligations would shift increasingly toward community needs assessments, investments in population health and health promotion, and the measurement and evaluation of the effectiveness of interventions executed to address the needs identified in community needs assessments. Under the ACA, each tax-exempt hospital must conduct a community health needs assessment every three years and invest annually in meeting the identified community health needs. The Hospital Community Benefit Program, therefore, will serve as a resource for state and local policymakers to ensure that hospitals’ community benefits advance the health of communities.
Beyond the ACA, state and local governments increasingly are evaluating whether the tax revenue they forego is justified by the community benefits provided by tax-exempt hospitals. State and local governments recognize that tax-exempt hospitals receive not only significant tax exemptions from the federal government (in the form of income and FUTA exemptions), but also significant tax exemptions from state and local governments (in forms such as exemptions from real and personal property taxes, income taxes, and sales taxes). With insurance coverage expansions on the horizon and continuing budget constraints, state and local governments have an active stake in the community benefits provided by tax-exempt hospitals as the charity care burden diminishes. Moreover, in order to retain a nonprofit tax-exempt mission into the future, the hospitals themselves have a keen interest in this topic as they strive to demonstrate to all levels of government the value of the community benefits they provide. In this emerging area of health policy, Hilltop’s Hospital Community Benefit Program will be the essential resource to help measure, compare, and evaluate whether the community benefits rendered by tax-exempt hospitals are appropriate and effective.
The Hospital Community Benefit Program will publish a series of issue briefs and will develop a website where best practices, new laws and regulations, and study findings will be disseminated broadly. The website will link to a broad array of resources, such as legislation, litigation, industry guidance, published research, and materials from state and local associations. There also will be news alerts, to keep the website timely and essential.
The initial funding for the Hospital Community Benefit Program will cover three years. Charles Milligan, JD, MPH, Hilltop’s executive director, is the principal investigator. Donna Folkemer, MA, comes to Hilltop from the National Conference on State Legislatures to direct the program.