Expectations and Efforts Regarding Community Benefit Spending

Benefiting the Community and those In Need
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Benefiting the Community and those In Need
Introduction
Many healthcare organizations in the United States (U.S) operate as nonprofit entities and, as a result, are exempted from local, state, and federal taxes. This favor tax status is tailored to recognize these institutions’ commitment to providing “community benefits.” Controversy exists within public domains regarding whether nonprofit health care facilities offer enough community benefits to meet the eligibility criteria for tax exemption. This led to scrutiny efforts at the federal level, leading to the inclusion of community benefits policies within the Affordable Care Act (ACA). Apart from being part of the approach to address ACA prioritization of population wellness and preventive care, these requirements were designed to enhance accountability and transparency within the healthcare system. This paper discusses the expectations of nonprofit hospitals concerning Community Benefit Spending, state efforts to ensure these organizations adhere to such expectations, and Maryland’s 2010-2016 performance in regards to community benefits requirements.
Expectations for Hospitals about Community Benefit Spending
The ACA has three key expectations for nonprofit hospitals regarding community benefits. First, nonprofit hospitals are expected to assess their community’s wellness needs every three years and design strategies to meet the identified needs. Accordingly, the healthcare organization should seek input from different community stakeholders, including public health leaders. The ACA requires that the assessment addresses financial and other constraints to care and the need to prevent disease and ensure sufficient nutrition, including addressing environmental, behavioral, and social factors influencing emergency preparedness or community health (James, 2016). Second, each nonprofit healthcare organization is expected to develop a written financial assistance program for medically necessary and emergency care. The financial assistance program should include essential information concerning whether the facility provides discounted or free care; the eligibility criteria for financial aid; details of the assistance application process; information about how much clients are expected to pay; the payment procedures they will employ; and measures the healthcare facility would take to publicize the program to the community (James, 2016).
Third, nonprofit hospitals are expected to comply with specified limits on charges, billing, and collection activities. According to Folkemer et al. (2011), Obamacare limited charges, billing, and collection efforts tailored for uninsured persons. Healthcare organizations might not participate in extraordinary collection activities before making efforts to establish qualifications for financial help. Moreover, hospitals are not expected to charge persons qualified for financial help more than they charge insured persons for similar care. In addition, nonprofit hospitals are expected to report to the Internal Revenue Service (IRS) the outcomes of the community health need...