Hospitals have a lot of leeway to decide who is eligible for financial assistance. In some cases, hospitals don't allow any elective care to be eligible. What impact could that have on health or medical debt? More
Register now for the webinar "America's Most Socially Responsible Hospitals" on June 25, 2025. More
Dr Vikas Saini is a Cardiologist and President of the Lown Institute, where he leads a non-partisan think tank advocating bold ideas for a just and caring system for health. With a unique background combining philosophy and medicine, Dr. Saini has spent decades examining the intersection of ethics, evidence, and economics in healthcare. His work on the Social Responsibility Index challenges traditional hospital rankings by measuring what truly matters: equity, value, and patient outcomes rather than reputation and revenue."The enterprise of medicine has both scientific and moral dimensions, and they're inextricably balanced"
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"When hospitals fail to make access to assistance easy and predictable, it drives people away from care and erodes trust in our entire system," Saini explained. "Right now, the burden is on patients to navigate a broken system. That has to change." More
“This isn’t a case of red states versus blue states, or rural areas versus cities,” Vikas Saini, MD, president of the Lown Institute, said in a June 2 news release from the organization. “We’re seeing massive disparities in charity care policies between hospitals that are practically around the corner from each other. Unfortunately, low- and middle-income patients are the ones who deal with the consequences.” More
Analysis of 2,500 charity care policies finds patients with identical income and medical needs could receive free care at one hospital, yet face collections or lawsuits at another. More
Medical debt impacts tens of millions of Americans, contributing to financial harm and worse health. This report provides an overview of research on prevalence, impact, and drivers of medical debt, finishing with policy recommendations to address both the downstream problem of medical debt and the systemic issues behind the problem. Suggested citation: Past Due: How Medical Debt is Harming Americans and the Solutions We Need Now. Medical debt working group. Needham, MA: The Lown Institute, 2025. More
“We’re all here because this issue is a moral stain on the fabric of the country… We’re also here because if we want to fix this, we can," Dr. Vikas Saini told the crowd at the 2025 Lown conference on Medical Debt in America. More
Hospitals in 18 states own a total of $170 billion in assessed real property value and benefit from a total of $4.3 billion in real estate tax exemptions. However, this benefit is not spread out equally among states. More
The recently released study was conducted by the Boston-based Lown Institute, an independent healthcare think tank. The organization examined 1,800 nonprofit hospitals in 20 states, using average numbers from 2020, 2021 and 2022.
These 20 hospitals avoided nearly $1 billion in property taxes. More
What types of initiatives are hospitals investing in to improve access to care and community health? We dug into the tax forms for some of the largest fair share surplus hospitals to find out. More
Nonprofit hospitals in Colorado face renewed scrutiny over how much they spend locally compared to the tax breaks they receive. More
Outside the Meijer grocery store in Fairfax, Lachelle Dixon-Harris said the Clinic and other local hospitals need to help residents afford services — especially students and elderly residents. “They should have access to affordable health care that meets their needs — those who live in the community, not those who are coming from outside of the community, not those who fly in from other countries," she said. More
Nonprofit hospitals across Michigan received far more economic benefit from their tax-exempt status than they spent annually in community support and charity care over a three-year period. More
Garber also noted that nonprofit hospitals, specifically, are required to gather information about their communities’ most pressing health needs. Although the IRS Form 990 filed by nonprofit organizations includes Schedule H section requesting community-related spending, the section “includes a lot of information that has nothing to do with health care at all,” she said. “There’s definitely a need for transparency on what are you doing to address the health needs,” she said.
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Saini said there isn’t a clear pattern between which hospitals choose to give back and which don’t. In fact, they often coexist. “In any given city, you can often find two hospitals — one of which is in a surplus and one of which is in a deficit,” he clarified. “So it really seems that we have a tale of two hospitals in our health care.” More
New York’s nonprofit hospital sector receives tax breaks worth more than $2 billion each year, with the expectation that they’ll provide free services and invest in their communities. But dozens are falling short on community benefit spending, a new report shows. More
The annual calculations by the Lown Institute call into question whether the value a nonprofit community hospital gives to communities lives up to the taxes it doesn't have to pay. More