Regardless of tax status, medical centers in markets with high medical debt do provide more charity care, according to an analysis by KHN and the Urban Institute, a Washington think tank. That’s important, said Dr. Vikas Saini, president of the Lown Institute, a nonprofit that grades hospitals on their quality and community benefits. But he asked: “Is a hospital truly serving its community if it’s pushing so many into debt?”
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In recent years, more people, like Keenan and Saini, have questioned whether nonprofit hospitals are contributing enough to their communities to deserve the major tax breaks they get while becoming some of the largest businesses in town. "The hospitals are sort of the pillars of communities, but people are starting to ask these questions," Saini says.
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Providence also owes some of its wealth to its nonprofit status. In 2019, the latest year available, Providence received roughly $1.2 billion in federal, state and local tax breaks, according to the Lown Institute, a think tank that studies health care.
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Although Bon Secours has taken a financial hit this year like many other hospital systems, the chain made nearly $1 billion in profit last year at its 50 hospitals in the United States and Ireland and was sitting on more than $9 billion in cash reserves. It avoids at least $440 million in federal, state and local taxes every year that it would otherwise have to pay, according to an analysis by the Lown Institute, a nonpartisan think tank.
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Mass General Brigham has said it will reduce its total medical spending by $127.8 million annually, nearly doubling its commitment to reduce its spending after months of discussions with a state watchdog agency. The filing is part of the hospital’s “performance improvement plan,” which was required by the state’s Health Policy Commission after what it said were years of spending above acceptable levels.
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Even in 2020, when many hospitals were refusing non-urgent surgeries, more than 100,000 unnecessary, and potentially harmful procedures were performed on older patients in the USA, according to anaylsis from health think-tank the Lown Institute.
"You couldn't go into your local coffee shop, but hospitals brought people in for all kinds of unnecessary procedures," said Vikas Saini, MD, president of the Lown Institute. "The fact that a pandemic barely slowed things down shows just how deeply entrenched overuse is in American healthcare."
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This percentage dropped to 24 percent for those who used three or more prescription drugs and 12.8 percent for those who used five or more prescription drugs. However, a report from the Lown Institute released in April 2019 shows that polypharmacy has reached epidemic proportions in the United States.
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“Citizens put their lives and billions of tax dollars in the hands of America’s hospitals,” said Vikas Saini, president of the Lown Institute, in a press release. “We believe communities should have expectations and the most socially responsible institutions should be lifted up as models for the system.”
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The social responsibility index is perhaps the Lown Institute’s highest-profile review of not-for-profit and nonprofit health care systems and hospitals. The institute’s focus is analyzing the socioeconomic impact of the systems and hospitals, particularly as it relates to the tax exemptions they receive compared with community benefits and the charity care they provide.
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In a new set of hospital rankings released last month, Duke Regional Hospital in Durham was named the nation’s second-most “socially responsible” hospital, while other Triangle- and North Carolina-based hospitals also received high marks. The rankings, released annually since 2020 by nonprofit think tank the Lown Institute, are the first “to define clear, measurable standards for hospital social responsibility, providing “benchmarks for hospitals to measure how well they serve their patients and communities.”
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