Shifts in Community Benefits Spending Among Nonprofit Hospitals in Nebraska and 10 Proximate States, 2012 and 2015.


Journal

Journal of public health management and practice : JPHMP
ISSN: 1550-5022
Titre abrégé: J Public Health Manag Pract
Pays: United States
ID NLM: 9505213

Informations de publication

Date de publication:
Historique:
pubmed: 4 6 2020
medline: 3 2 2022
entrez: 4 6 2020
Statut: ppublish

Résumé

Federal and state policy makers have debated the evolving concept of community benefit and the extent to which nonprofit hospitals are providing benefits to the community in exchange for the tax benefits they receive. This study compares community benefits spending by nonprofit hospitals in Nebraska and other selected states in both 2012 and 2015. Expenditures are also examined by rural, regional, and urban hospitals within Nebraska. Community benefit expenditure data were taken from Community Benefit Insight and consolidated into the categories of direct patient care, community health improvement initiatives, and health professions education and research. When community benefit expenditures were compared across 11 states, Nebraska had the highest percentage of expenditures for community health improvement initiatives in both 2012 and 2015. Although community benefit expenditures for the 44 nonprofit hospitals within Nebraska increased from 2012 to 2015, they remained flat as a share of total hospital expenditures. In 2015, 63% of community benefit expenditures were allocated to direct patient care, which represented a 7.3% decrease from 2012. This decline led to greater spending on community health improvement initiatives (3.1%) and health professions education and research (4.2%). Rural, regional, and urban hospitals spent more proportionately on community health improvement initiatives in 2015 than in 2012. The shift in community benefit expenditures from direct patient care to community health improvement initiatives and health professions education and research suggests that hospitals are investing in programs with broader community-wide benefits. Nebraska allocates a significantly larger share of its community benefits spending to community health improvement activities than other Great Plains and Midwestern states. Nebraska is in the process of implementing Medicaid expansion, which may shift future community benefits spending decisions.

Identifiants

pubmed: 32487922
pii: 00124784-202201000-00028
doi: 10.1097/PHH.0000000000001175
doi:

Types de publication

Journal Article

Langues

eng

Pagination

E73-E80

Informations de copyright

Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

The authors have indicated they have no potential conflicts of interest to declare.

Références

Congressional Budget Office. Nonprofit Hospitals and the Provision of Community Benefits. Washington, DC: Congressional Budget Office; 2006.
Rosenbaum S, Kindig DA, Bao J, Byrnes MK, O'Laughlin C. The value of the nonprofit hospital tax exemption was $24.6 billion in 2011. Health Aff (Millwood). 2015;34(7):1225–1233.
Gale J, Croll Z, Coburn A, Croom J. Comparing the community benefit spending of critical access, other rural, and urban hospitals. Flex Monitoring Team Policy Brief #45. http://www.flexmonitoring.org/wp-content/uploads/2016/11/PB45.pdf. Published November 2016. Accessed January 6, 2020.
Topko L, ElRayes W, Palm D, Chen L, Larson J. A Comparison of the Community Benefit Expenditures in Rural, Regional, and Urban Nonprofit Hospitals in Nebraska, 2010-2014 [Report No, PR2017-4]. Omaha, NE: College of Public Health, UNMC & Office of Rural Health, Nebraska Department of Health and Human Services; 2017.
Leider JP, Tung GJ, Lindrooth RC, Johnson EK, Hardy R, Castrucci BC. Establishing a baseline: community benefit spending by not-for-profit hospitals prior to implementation of the Affordable Care Act. J Public Health Manag Pract. 2017;23(6):e1–e9.
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Begun JW, Trinh HQ. Determinants of community-related expenses of US tax-exempt hospitals, 2013. J Public Health Manag Pract. 2019;25(4):316–321.
Community Benefit Insight. http://www.communitybenefitinsight.org. Accessed October 15, 2019.
US Census Bureau. 2017 national and population estimates. https://www.census.gov/newsroom/press-kits/2017/estimates-demographics.html. Published December 20, 2017. Accessed October 15, 2019.
Kaiser Family Foundation. Status of station action on the Medicaid expansion decision. https://www.kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D. Published 2019. Accessed February 24, 2020.
Chartis Center for Rural Health. Nebraska critical access hospital conference on quality: the rural health safety net and key considerations for rural healthcare leaders. https://nosorh.org/wp-content/uploads/2020/01/CCRH_NOSORH-Webinar-Jan2020_FNL.pdf. Published January 30, 2020. Accessed February 24, 2020.
Barrow T. States step in to fill regulatory void over community benefits. Modern Healthcare. https://www.modernhealthcare.com/not-profit-hospitals/states-boosting-regulation-hospital-community-benefits-spending. Published August 3, 2019. Accessed January 6, 2020.
Palm D, Grimm B, Pacino V, Kamara V. The Integration of Public Health and Primary Care: An Environmental Scan of Nebraska. Omaha, Nebraska: University of Nebraska Medical Center; 2019.

Auteurs

David Palm (D)

Department of Health Services Research and Administration (Dr Palm and Ms Pacino) and Department of Health Promotion (Dr Grimm), University of Nebraska Medical Center, College of Public Health, Omaha, Nebraska.

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