Author: Publisher: ISBN: Category : Languages : en Pages : 0
Book Description
Research Context • What do tax-exempt hospitals provide in terms of community benefits? • What are key determinants of the type and level of benefits provided (i.e., hospital, community, and market)? Research Context Previous research limitations: • Lack of standard approaches to defining and measuring community benefit. [...] Adoption of Form 990, Schedule H (mandatory in 2009) • Charity care • Unreimbursed costs from means-tested government insurance programs • Subsidized health services • Community health improvement/community benefit operations • Cash/Inkind contributions to community groups • Research • Health professions education Research Context Schedule H also requires hospitals to report data for three additio. [...] Results: Analytical Models • Key determinants for patient-care benefits: - State community benefit reporting requirements • Key determinants for community-service benefits: - State community benefit reporting requirements - Sole community provider - Teaching hospital (i.e., COTH membership) Hospital Community Benefit Expenditures, According to the Percentage of Uninsured Residents Conclusions • Si. [...] • Health reform generally may encourage shift in pattern of community benefit expenditures in the direction of community health improvement. [...] Hospitals Research Team Policy Context Policy Context Research Context Research Context Research Context Research Context Study Methods Universe versus Study Population Methods Results: Community Benefitsas Percentage of Operating Expenses Distribution of Community Benefit Expenditures among Benefit Types Slide Number 14 Results: Distribution of Hospitals among Community Benefit Measures Results:.
Author: Susannah Camic Tahk Publisher: ISBN: Category : Languages : en Pages : 0
Book Description
Hospitals in the U.S. have long been able to obtain exemption from federal income tax because they meet the requirement known as the standard of “community benefit.” Yet lawmakers and scholars know virtually nothing about the actual workings of tax-exempt hospitals, or about whether, how, and to what extent they deliver benefits to their communities. Within the last five years, however, IRS tax return forms have started asking hospitals to quantify these benefits, as well as to give detailed information about their financial practices with respect to their patients. These new questions coincide with new requirements for tax-exempt hospitals put in place as part of 2010's health care reform bill, the Affordable Care Act. The new tax return data offers a first-time opportunity to evaluate the workings of tax-exempt hospitals from the perspective of both the traditional requirements for tax-exempt hospitals and the 2010 reforms of the Affordable Care Act. This Article analyzes data from all tax-exempt hospitals in the U.S. in 2012 to show that tax-exempt hospitals differ widely in their provision of community benefits (and financial practices). In particular, these activities vary systematically in relation to their different notions of “community” and the characteristics of the communities where the hospitals are located. This evidence demonstrates that tax-exempt hospitals seem to be responding to the specific needs of their own communities when allocating their resources among different community-benefit activities. The data show, in addition, that while tax-exempt hospitals are generally adopting the financial policies that Congress and the IRS are requesting, hospital financial aid policies also vary by community. These findings raise several fundamental questions for lawmakers and tax policy scholars in the era of the Affordable Care Act. In particular, the findings suggest that lawmakers need to grapple seriously with how they allow tax-exempt hospitals to define their communities. For example: is it appropriate for tax-exempt hospitals merely to benefit a narrowly defined community or should they operate in terms of a broader understanding of community? In light of the new data presented, this Article considers these questions and outlines several alternatives to the “community benefit” standard to address them.
Author: Wael Mohamed Fathy ElRayes Publisher: ISBN: Category : Languages : en Pages : 231
Book Description
The Internal Revenue Service issued the long awaited regulatory guidelines for the Community Benefits (CB) spending for private tax-exempt hospitals in December 2008, which required these hospitals to report their policies, practices, and spending on CB activities. The Affordable Care Act amended these rules in 2010 by adding a section on Community Health Needs Assessment. This study evaluates and tracks spending on the total and different CB activities by all private tax-exempt hospitals in seven states after the implementation of the latest IRS and ACA reporting regulations from 2010 - 2013. Moreover, this study investigates which community health indicators are predictive of spending on community improvement activities. The last part of this study examines the relationship between spending on health improvement activities and changes in a set of health indicators. We collected data from multiple sources and hospitals’ CB data were obtained from revised income tax Form 990. A total of 328 private tax-exempt hospitals in the states of Kentucky, Minnesota, Mississippi, Nebraska, New Hampshire, New Mexico, and Virginia were included in the first study. The second and third studies included the 223 counties that had at least one private tax-exempt hospital in the seven states. Univariate analyses provided basic analyses. Multivariate regressions analyses, including linear and nonlinear models, examined the relationships between different predictor and response variables while adjusting for multiple covariates. SAS/STAT version 9.4 statistical software was used to execute the analyses. A p-value of ≤ 0.05 was considered statistically significant. Total annual CB spending increased significantly between 2010 and 2013. There were considerable variations in the amounts and types of CB spending between different private tax-exempt hospitals. Direct patient care spending dominated the amount of spending on CB. Community health improvement initiatives comprised only around 0.55% of total tax-exempt spending on CB activities and varied considerably between counties and states and over time. Community health indicators showed mixed patterns over the study period. There did not appear to be a consistent pattern between the spending on community health improvement initiatives and changes in community health indicators.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309166616 Category : Medical Languages : en Pages : 429
Book Description
The United States is rapidly transforming into one of the most racially and ethnically diverse nations in the world. Groups commonly referred to as minorities-including Asian Americans, Pacific Islanders, African Americans, Hispanics, American Indians, and Alaska Natives-are the fastest growing segments of the population and emerging as the nation's majority. Despite the rapid growth of racial and ethnic minority groups, their representation among the nation's health professionals has grown only modestly in the past 25 years. This alarming disparity has prompted the recent creation of initiatives to increase diversity in health professions. In the Nation's Compelling Interest considers the benefits of greater racial and ethnic diversity, and identifies institutional and policy-level mechanisms to garner broad support among health professions leaders, community members, and other key stakeholders to implement these strategies. Assessing the potential benefits of greater racial and ethnic diversity among health professionals will improve the access to and quality of healthcare for all Americans.
Author: Jessica Wilen Berg Publisher: ISBN: Category : Languages : en Pages : 0
Book Description
Disputes about tax-exemption are occurring all over the country. The IRS and CBO are engaged in national studies of non-profit hospitals and community benefits. State governments are considering whether to legislate minimum amounts of charity care in exchange for tax-exemption. Congress is debating whether hospitals should remain a part of the non-profit sector at all. At the same time, uninsured individuals are suing hospitals for unfair billing and collection practices. Creative accounting and expansive definitions of "free" care have led to a variety of non-ideal practices by hospitals in order to balance their bottom line, while at the same time maintain tax-exempt status. This article argues that the longstanding focus on providing individual charity care to meet the community benefit standard for tax-exemption is misguided. Instead, I determine that there are conceptual and practical arguments for requiring hospitals to provide population or public health benefits. I offer a detailed analysis for implementing a new standard, and a framework for quantifying community benefit under that standard. The suggestions set forth should result in better, more expansive benefits for communities; clearer guidance for health care institutions and tax authorities; and fewer problematic incentives for tax-exempt hospitals attempting to meet their community benefit obligations.
Author: Mark Patrick Martz Publisher: ISBN: Category : Community health services Languages : en Pages : 207
Book Description
In the United States, under the provisions set forth by a policy known as community benefit, nonprofit hospitals receive special tax exemptions from government in exchange for providing a wide range of health care services to the communities in which they are located. In recent years, nonprofit hospitals have claimed billions of dollars as community benefit justifying their tax-exempt status. However, growing criticism by numerous stakeholders has questioned the extent to which the level of community benefit claimed by nonprofit hospitals reflects the exemptions they receive. In addition, a dearth of research exists to understand the relationship between community benefit claims and the impact they have on improving the health of communities. In an effort to better understand the relationship between community benefit claims, tax status, and community health outcomes this study examines the community benefit policies of a nonprofit healthcare system representing hospitals in California, Nevada, and Arizona. It does so by reviewing materials produced by the system, her hospitals, vested stakeholders, and government that have shaped the development, implementation, and assessment of community benefit policy processes. Findings of the study suggest that the majority of nonprofit hospital community benefit claims are consumed by shortfalls reported between costs associated with providing care to Medicare and Medicaid patients and the compensation nonprofit hospitals receive from government. Results of the study also demonstrate that community benefit policies do positively impact the health of communities. However, future community benefit policies need to be refined to include measures that capture the magnitude of community health improvement if the relationship between policy and health outcomes is to be fully realized.
Author: California. Office of Statewide Health Planning and Development Publisher: ISBN: Category : Community health services Languages : en Pages : 102
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309036437 Category : Medical Languages : en Pages : 580
Book Description
"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.
Author: 
Author: Susannah Camic Tahk
Author: United States. Congress. House. Committee on Ways and Means
Author: Wael Mohamed Fathy ElRayes
Author: Institute of Medicine
Author: Jessica Wilen Berg
Author: Mark Patrick Martz
Author: United States. General Accounting Office
Author: California. Office of Statewide Health Planning and Development
Author: Institute of Medicine