WATCH: What is the responsibility between hospitals and communities?

2022 Medicaid Institute hosted by the Center for Community Solutions, featuring Lown Institute experts Dr. Vikas Saini and Judith Garber

Last week, Lown experts Dr. Vikas Saini and Judith Garber were featured at the 2022 Medicaid Institute, hosted by the Center for Community Solutions. 

The 2022 Medicaid Institute fostered a conversation about the responsibility between hospitals and the community. In Ohio, where the Center for Community Solutions is based, Medicaid covers around a quarter of the residents, half of the births, and the majority of older and disabled residents. The healthcare sector also makes up a large portion of the economy. With these factors in mind, the Center for Community Solutions and the Lown Institute examined Ohio hospitals’ community benefit spending.

Community benefit standards have shifted over the years, though the vast majority of spending reported is actually Medicaid shortfall. At Lown, we believe that to qualify as “community benefit spending”, money must be spent on activities that provide a direct and meaningful benefit to the local communities. This includes charity care, community health improvement activities, contributions to community groups, community-building activities to address the social determinants of health, and subsidized health services. Comparing community spending with nonprofit hospitals’ annual tax exemptions calculates the total Fair Share Spending. Ohio is one of seven states for which the fair share spending reached over a billion-dollar deficit – in other words, nonprofit hospitals in Ohio are receiving over a billion dollars in tax breaks and are not investing that money back into their communities as promised. 

It’s not that nonprofit hospitals are intentionally siphoning off public funding through tax breaks, but more so a systemic issue with how we fund our healthcare system. Some nonprofit hospitals, especially ones that are smaller and in rural areas, have been struggling financially for years. In those cases, hospitals may be toeing the line of closing their doors for good.

“Hospitals want to do the right thing, they want to do this. They’ve got their own constraints, so in some ways, there’s a real opportunity for community leaders and hospitals to create alliances to change the regulatory and policy environment.”

– Lown President Dr. Vikas Saini at the 2022 Medicaid Institute

Watch the recording to learn more about the responsibility between hospitals and the community and how we can move towards an equitable, just, and caring system for health.