Hospital Community Benefits After the ACA: Present Posture, Future Challenges

This report, published by the The Hilltop Institute’s Hospital Community Benefit Program, is the eighth report in a series, Hospital Community Benefits after the ACA, funded by the Robert Wood Johnson Foundation (RWJF) and the Kresge Foundation. The series began in January 2011 with The Emerging Federal Framework and has addressed important policy issues surrounding hospital community benefits.

Hospital Community Benefits after the ACA: Present Posture, Future Challenges, examines in detail the Internal Revenue Service’s (IRS’s) 2013 proposed rules, “Community Health Needs Assessments for Charitable Hospitals,” and their potential impact on nonprofit hospital needs assessment, community benefit planning, and collaborative approaches to community health improvement.

Throughout the report, the authors raise a variety of decision points nonprofit hospitals will face as they adapt to new care delivery models, new payment structures, and heightened expectations of quality efficiency and accountability in their delivery of health care services. Some of those questions include: how to define community, should they work on a collaborative community health needs assessment, what will the role of the public be, what impact will Medicaid expansion have on reducing unreimbursed care, will community benefit policies encourage improvements in upstream issues affecting health like housing and education, and many more.