A Comparison of Nonprofit Hospital Charity Care Policies and Community Benefit in Central Ohio to Peer Cities

Sarah Clagg, Andrew Wapner, Jeff Klingler, S. Schweikhart
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Abstract

Background: Nonprofit hospitals in the United States are required to provide community benefits, including charity care, to receive tax exemption from the federal government. Central Ohio's nonprofit hospitals have agreed to the same charity care policies, which may be unique compared to other communities across the county. The aim of this research is to compare the charity care policies of hospitals in Columbus, Ohio, to their peer cities, investigating if hospitals in similar cities have common shared charity care thresholds and to determine if hospitals in peer cities provided similar levels of community benefit. Methods: Tax data from nonprofit hospitals in 21 cities were collected and analyzed using Microsoft Excel (Microsoft Corporation). City community benefit data was summed and averaged using Excel to create a graphical representation of the data. Results: Only Columbus, Ohio, and Providence, Rhode Island, reported the same charity care thresholds across hospitals. Data demonstrate that Columbus provides less community benefit in dollars to total expenses compared to peer cities; however, this appears to be only true regarding other community benefit excluding charity care. Columbus was near the median among cities examined in regard to percentage of charity care to total community benefit. Conclusion: Results suggest variability in the amount and type of community benefit nonprofit hospitals provide. Central Ohio hospitals have the same charity care thresholds and spent approximately the same in total community benefit however it is not transparent how these funds are utilized. Current federal regulations do not assess whether the community benefits reported are affecting community health outcomes.
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俄亥俄州中部与同行城市非营利性医院慈善护理政策及社区效益比较
背景:美国的非营利性医院必须提供社区福利,包括慈善护理,才能获得联邦政府的免税待遇。俄亥俄州中部的非营利性医院也同意同样的慈善护理政策,这与全县其他社区相比可能是独一无二的。本研究的目的是将俄亥俄州哥伦布市医院的慈善护理政策与同行城市进行比较,调查相似城市的医院是否有共同的慈善护理门槛,并确定同行城市的医院是否提供了相似的社区福利水平。方法:采用Microsoft Excel软件对21个城市非营利性医院的税务数据进行收集和分析。使用Excel对城市社区福利数据进行汇总和平均,以创建数据的图形表示。结果:只有俄亥俄州哥伦布市和罗德岛州普罗维登斯市报告了不同医院相同的慈善护理阈值。数据显示,与其他城市相比,哥伦布提供的社区收益占总开支的比例较低;然而,这似乎只适用于其他社区利益,不包括慈善关怀。在接受调查的城市中,哥伦布的慈善服务占社区总收益的比例接近中位数。结论:结果表明非营利性医院提供的社区福利的数量和类型存在差异。俄亥俄州中部的医院有相同的慈善护理门槛,在社区福利总额上的支出也大致相同,但这些资金的使用方式并不透明。目前的联邦法规没有评估报告的社区福利是否正在影响社区健康结果。
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