The Hilltop Institute's Hospital Community Benefit Program

Resources and issue briefs illuminate new community benefit requirement for tax-exempt hospitals and provide tools for policy-makers.

Historically, nonprofit hospitals, as a condition of their tax-exempt status, have been required to enhance the health and welfare of their communities, which they have done largely through the provision of charity care. Through changes stemming from the Patient Protection and Affordable Care Act (ACA), nonprofit hospitals will have the opportunity to direct their community benefit efforts toward public health interventions and collaborate more effectively with local health departments. The ACA, for example, requires nonprofit hospitals to:

  • Complete community-health-needs assessments regularly;
  • Take into account input from persons representing community interests, including public health experts, when developing the assessment;
  • Adopt a plan to meet the community health needs identified through the assessment; and
  • Report annually how it is addressing the needs identified in the most recent community-health-needs assessment and explaining why any identified needs are not being addressed.

Similarly, more local health departments are moving toward the goal of conducting community health assessments regularly both to ensure alignment between their programs and services and community needs; and to meet the prerequisites of the national accreditation system being launched in 2011 by the Public Health Accreditation Board. Collaborating around the design and implementation of community needs assessments, as well as around other prevention-related activities, will enable nonprofit hospitals and local health departments to use their scarce resources more efficiently and effectively through improved coordination and reduced duplication of programs and services.

The Hilltop Institute’s Hospital Community Benefit Program, which is funded by the Robert Wood Johnson Foundation and the Kresge Foundation, identifies new challenges and opportunities for state and federal decision-makers as they begin to develop responses to the new federal requirements. Through the three-year program, Hilltop will release a series of eight issue briefs on topics relevant to community benefit. The two most recent briefs are: Schedule H and Hospital Community Benefit–Opportunities and Challenges for the States and Community Building and the Root Causes of Poor Health. The previous three briefs included: The Emerging Federal Framework, Building on State Experience and Partnership for Community Health Improvement.