Tax-exempt hospitals' community benefit spending essentially stayed the same following implementation of the current health law, according to a study published in Health Affairs.
For the study, researchers examined tax-exempt hospitals' net expenditures for community benefits, as reported on IRS Form 990 Schedule H. The study involved approximately 2,000 tax-exempt general hospitals during the period of 2010 to 2014.
The study found tax-exempt hospitals' average spending on all community benefits — such as charity care, unreimbursed costs for means-tested government programs, subsidized health services, direct spending on community health, contributions to community groups, research and health professions education — rose 0.5 percent between 2010 and 2014, from 7.6 percent to 8.1 percent. The study authors largely attributed the increase, which took place by 2012, to patient care benefits spending.
Spending on community health and other types of community benefits remained essentially unchanged from 2010 to 2014, according to the study.
Researchers said they also found hospitals that don't face relatively high charity care demand spend substantially more on community health initiatives than those that do.
The study does point out the ACA's provision requiring tax-exempt hospitals to conduct routine community health needs assessments took effect for most hospitals in 2012, and the health law's Medicaid expansion began in 2014.
"Certainly, more time is needed to see whether hospitals' spending on community benefits begins to move in a direction that is in line with key U.S. health policy goals. However, even if ACA-related expansions of health insurance do help free up financial resources for hospitals to invest in community health, many hospitals may lack the infrastructure and competencies necessary for effectively engaging in community health initiatives," the study authors concluded.
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