The Hospital Community Benefit Program, established by The Hilltop Institute at the University of Maryland, Baltimore County (UMBC), is the central resource for state and local decision-makers who seek to ensure that tax-exempt hospital community benefit activities are more responsive to pressing community health needs. One of the program’s functions is to publish a series of issue briefs on promising practices, new laws and regulations, and study findings on community benefit activities and reporting.

The first issue brief in the series explored the expanded regulatory framework for hospital community benefits under the Affordable Care Act (ACA), outlining its new community benefit requirements and exploring the challenges and opportunities these present for state policy-makers.

This is the second issue brief in a series, funded by the Robert Wood Johnson Foundation and the Kresge Foundation, to be published over three years. It takes a closer look at three aspects of community benefits affected by §9007 of the ACA, “Additional Requirements for Nonprofit Hospitals”:

  • Community health needs assessment
  • Hospital financial assistance and billing and collection policies
  • Community benefit reporting and oversight strategies

This brief considers each of these requirements against a backdrop of federal and state law and practice. This is not a comprehensive account of state experience. Rather, these examples illustrate a range of state policy decisions that can help to inform the interpretation and implementation of §9007 of the ACA.