Hospital Community Benefits after the ACA

Policy Implications of the State Law Landscape

The Community Benefit State Law Profiles (Profiles), launched in March 2013 by The Hilltop Institute’s Hospital Community Benefit Program, analyze each state’s community benefit laws, regulations, and policies. Two briefs, funded by the Robert Wood Johnson Foundation (RWJF) and the Kresge Foundation, were developed to explore the Profiles in more detail to help state policy-makers, nonprofit hospitals, and stakeholders better understand each state’s policies in light of federal community benefit benchmarks and requirements of other states.

The first companion brief to the Profiles, Hospital Community Benefits after the ACA: The State Law Landscape explored the Affordable Care Act’s standards that nonprofit hospitals must meet for federal tax exemption, and compared those standards to the regulations and policies required by each state.

This second companion brief, Hospital Community Benefits after the ACA: Policy Implications of the State Law Landscape, released in September 2013, describes state community benefit requirements organized into eight categories that largely reflect either pre-existing federal community benefit standards or additional requirements set forth in the Affordable Care Act (ACA).

The second brief concludes that the role of nonprofit hospitals in a post-ACA environment will be affected by significant changes in other evolving aspects of the health care system, including changes in health care delivery and payment systems and the current trend toward industry consolidation. All of these changes are likely to affect nonprofit hospital community benefit opportunities and obligations; they should be taken into consideration as states reassess their community benefit regulatory frame works and evaluate options for the future.

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