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Understanding the relationship between nonprofit hospital community benefit spending and system membership: An analysis of independent hospital acquisitions. | LitMetric

AI Article Synopsis

  • The IRS mandates nonprofit hospitals to report community benefit spending to maintain their tax-exempt status, prompting a study on how hospital acquisitions affect this spending.
  • Analyzing data from 57 acquired nonprofit hospitals between 2011-2018, the study used difference-in-differences methods to evaluate changes in community benefit spending.
  • Findings showed that hospital acquisitions resulted in reduced spending on population health and other categories, particularly when the acquirer was from out-of-state, underscoring the need to consider community benefit alongside other factors when assessing the impact of hospital acquisitions.

Article Abstract

The Internal Revenue Service (IRS) requires nonprofit hospitals to report community benefit spending to justify their nonprofit tax exemption. We examined whether nonprofit hospital acquisitions influence the amount and type community benefit spending. We analyzed 2011-2018 data on urban, nonprofit hospitals. The analysis dataset included 57 hospitals that were acquired and a matched control group. We estimated difference-in-differences specifications to measure the effect of acquisitions on total community benefit spending, and three subcategories - clinical, population health, and other spending types. We found that acquisitions led to decreased population health spending (-$0.32 million, p < 0.01) and other spending categories (-$1.5 million, p < 0.05), but no significant change in total or clinical spending. If the acquirer was located out-of-state, total community benefit spending declined by $2.4 million (p < 0.10). Our findings support the need for community benefit spending to be considered, along with quality, efficiency, and prices, when evaluating the welfare impact of acquisitions.

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Source
http://dx.doi.org/10.1016/j.jhealeco.2022.102696DOI Listing

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