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Analysis of hospital community benefit expenditures' alignment with community health needs: Evidence from a national investigation of tax-exempt hospitals

Author

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  • Singh, S.R.
  • Young, G.J.
  • Lee, S.-Y.D.
  • Song, P.H.
  • Alexander, J.A.

Abstract

Objectives: We investigated whether federally tax-exempt hospitals consider community health needs when deciding how much and what types of community benefits to provide. Methods: Using 2009 data from hospital tax filings to the Internal Revenue Service and the 2010 County Health Rankings, we employed both univariate and multivariate analyses to examine the relationship between community health needs and the types and levels of hospitals' community benefit expenditures. The study sample included 1522 private, tax-exempt hospitals throughout the United States. Results: We found some patterns between community health needs and hospitals' expenditures on community benefits. Hospitals located in communities with greater health needs spent more as a percentage of their operating budgets on benefits directly related to patient care. By contrast, spending on community health improvement initiatives was unrelated to community health needs. Conclusions: Important opportunities exist for tax-exempt hospitals to improve the alignment between their community benefit activities and the health needs of the community they serve. The Affordable Care Act requirement that hospitals conduct periodic community health needs assessments may be a first step in this direction.

Suggested Citation

  • Singh, S.R. & Young, G.J. & Lee, S.-Y.D. & Song, P.H. & Alexander, J.A., 2015. "Analysis of hospital community benefit expenditures' alignment with community health needs: Evidence from a national investigation of tax-exempt hospitals," American Journal of Public Health, American Public Health Association, vol. 105(5), pages 914-921.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2014.302436_8
    DOI: 10.2105/AJPH.2014.302436
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    Cited by:

    1. Owsley, Kelsey M. & Lindrooth, Richard C., 2022. "Understanding the relationship between nonprofit hospital community benefit spending and system membership: An analysis of independent hospital acquisitions," Journal of Health Economics, Elsevier, vol. 86(C).
    2. Desai, Sunita M. & Padmanabhan, Prianca & Chen, Alan Z. & Lewis, Ashley & Glied, Sherry A., 2023. "Hospital concentration and low-income populations: Evidence from New York State Medicaid," Journal of Health Economics, Elsevier, vol. 90(C).

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