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- Title
State-Level Community Benefit Regulation and Nonprofit Hospitals' Provision of Community Benefits.
- Authors
Singh, Simone R.; Young, Gary J.; Loomer, Lacey; Madison, Kristin
- Abstract
Do nonprofit hospitals provide enough community benefits to justify their tax exemptions? States have sought to enhance nonprofit hospitals' accountability and oversight through regulation, including requirements to report community benefits, conduct community health needs assessments, provide minimum levels of community benefits, and adhere to minimumincomeeligibility standards for charity care.However, little research has assessed these regulations' impact on community benefits. Using 2009-11 Internal Revenue Service data on community benefit spending for more than eighteen hundred hospitals and the Hilltop Institute's data on community benefit regulation, we investigated the relationship between these four types of regulation and the level and types of hospital-provided community benefits. Our multivariate regression analyses showed that only community health needs assessments were consistently associated with greater community benefit spending. The results for reporting and minimum spending requirements were mixed, while minimum income eligibility standards for charity care were unrelated to community benefit spending. State adoption of multiple types of regulation was consistently associated with higher levels of hospital-provided community benefits, possibly because regulatory intensity conveys a strong signal to the hospital community that more spending is expected. This study can inform efforts to design regulations that will encourage hospitals to provide community benefits consistent with policy makers' goals.
- Subjects
UNITED States; NONPROFIT organization laws; STATE governments; NONPROFIT organizations; HEALTH facility administration; MULTIPLE regression analysis; COMMUNITY-based social services; UNCOMPENSATED medical care; TAXATION
- Publication
Journal of Health Politics, Policy & Law, 2018, Vol 43, Issue 2, p229
- ISSN
0361-6878
- Publication type
Article
- DOI
10.1215/03616878-4303516