Hospitals challenge Lown Institute's community benefits rankings

The American Hospital Association is slamming the Lown Institute's report on hospital community benefits, which ranks organizations based on how their charity care and community investment spending stacks up against the value of their tax exemption. 

The report from the nonpartisan healthcare think tank was released April 12. For the rankings, researchers calculated fair share spending for more than 1,800 hospitals across 275 nonprofit hospital systems based on hospital tax filings from fiscal year ending 2018 or 2019, whichever was the most recent year available. 

Each system's spending on charity care and community investment was compared to the value of its tax exemption. Systems were considered to have a fair share deficit if their spending on charity care and community investment was less than the value of their tax exemption. They were considered to have a fair share surplus if their spending on charity care and community investment exceeded the value of their tax exemption. 

Rick Pollack, president and CEO of the AHA, said in an April 12 blog post that the Lown Institute report is "an obvious example of relying on preconceived notions and faulty methodology to draw inaccurate conclusions."

Specifically, Mr. Pollack said the report ignores certain categories of community investment, such as researching lifesaving treatments and cures and training and educating the healthcare workforce. 

"It overlooks many of the essential contributions hospitals make to their communities that are critically important, especially during the pandemic," he said. "For example, a number of hospitals invested considerable funds and expertise into developing COVID-19 tests after setbacks from public health agencies. Hospitals also expanded treatment capacity especially as COVID-19 cases surged, established vaccine clinics and launched outreach campaigns to ensure everyone has access to vaccines, to name just a few examples."

Mr. Pollack also said financial assistance is not the only part of a hospital's community benefit, and the Lown Institute does not include all the services hospitals provide to their communities, such as programs that address housing needs, accessing nutritious food, educational and wellness programs, health screenings, transportation for patients, and other programs and services to address the needs that affect people's health and address the social determinants of health.

Additionally, he said hospitals take on many uncompensated and unreimbursed costs, and they subsidize costs related to many essential services they provide, such as burn and neonatal units. 

"America's hospitals and health systems do more than any other part of the healthcare field to support vulnerable patients and communities: Our doors are always open, regardless of a patient’s ability to pay," Mr. Pollack concluded. "In total, hospitals of all types have provided nearly $745 billion in uncompensated care to patients since 2000."



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