Haider Warraich, MD, a fellow in cardiology at Duke University Medical Center in Durham, N.C., argues in a STAT op-ed that leading nonprofit hospitals need to earn their tax exempt status by becoming more accountable to their communities.
Dr. Warraich points out that although many of the country's most profitable hospital systems were given tax-exempt status in exchange for providing benefits to their communities, they often fail to improve community health.
"Even as many nonprofit hospitals have seen record profits, their contributions back to the community have dwindled since [the] passage of the Affordable Care Act," Dr. Warraich wrote.
As payment models move toward rewarding hospitals on their quality of care rather than the volume of their services, hospitals may no longer be able to overlook community health. If they do not redirect their care toward community needs, Dr. Warraich fears they may risk losing their nonprofit status. Therefore, hospitals need to better define what constitutes a "community benefit," Dr. Warraich added.
Dr. Warraich offers four ways to make hospitals more accountable to their communities:
1. Match marketing budgets with community benefit contributions.
2. Redefine reimbursements toward payment models that base reimbursement on the community's health outcomes.
3. Require hospital boards to include community leaders who can advocate for different community needs.
4. Give a fixed percentage of earnings back to the community by funding research for community health projects or developing necessary infrastructure to transition to population-based payment models.