The Lown Hospitals Index 2022 Community Benefit ranking found the Clinic had the fourth-highest fair share deficit among U.S. nonprofit hospitals at $611 million. The fair share deficit is the difference between the estimated amount a hospital system receives in tax breaks versus the amount it directly invests into its community.
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Some of the largest not-for-profit U.S. hospital systems get a bigger benefit from their tax breaks than they pay out in charity care for the poor, implying that society isn’t benefiting much from their tax-free status, according to a new report.
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“It’s important for all of us to start understanding exactly how tax exemptions are working and what we’re actually getting for it,” says Dr. Vikas Saini, president of the Lown Institute. “The dollars we’re not seeing in taxes are dollars that could be spent on education, firefighters, police and safety, nutrition programs—you name it.”
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Nonprofit hospital systems are expected to give back to their communities in amounts that justify their massive tax breaks. But a new report from the Lown Institute shows this is rarely the case.
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“It’s an important issue because our nonprofit hospitals really are participants in a social compact,” said Dr. Vikas Saini, president and CEO of the Lown Institute, a Massachusetts-based nonprofit. “This is now a big business, there are many many dollars flowing through. It behooves us to understand what the tax exemption is doing, what it’s for and whether it’s still a fair dispensation.”
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What goes into measuring the "world's best hospitals"?
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Register now for our Fair Share launch on April 12!
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The approval of Alzheimer's drug Aduhelm through the accelerated pathway has brought new attention to needed improvements to this process.
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There've been a variety of awards in recent years for the organization now known collectively as Bitterroot Health. But the latest from the LOWN Institute is unique, rating 3,000 hospitals and health care systems on criteria such as social responsibility with regard to cost, healthy outcomes and benefits to a community.
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During this 33 minute conversation Dr. Saini and Ms. Garber discuss CEO bonuses during the pandemic, discuss generally CEO compensation as an outlier in the nonprofit sector, discuss the substance of their research findings including what explains CEO compensation and conclude by discussing what criteria should be used in calculating CEO compensation.
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The health care industry will soon be offering elective surgery where Americans once bought their underpants. “There is a certain logic to it,” said Vikas Saini, a cardiologist who is head of the Lown Institute, a think tank. He sees it as part of a general trend “towards the commercialisation of healthcare”.
Dr Saini thinks that malls in wealthier suburbs might hold a particular allure for hospitals. “The most desirable patient is the upscale patient who is healthy, who has commercial insurance and who can get some kind of elective surgery, like their knee or something, that’s very lucrative,” he said.
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Do nonprofit hospitals have higher unreimbursed Medicaid costs than for-profit hospitals?
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Patient advocates and researchers uncover concerning patterns in financial relationships between industry funding and patient advocacy organizations.
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The pandemic has brought hospital finances and pay scales to greater attention as burned out healthcare workers call for higher pay after two years of COVID-19, though hospital CEOs have faced scrutiny for years over sky-high compensation.
"Today, hospital boards compare the compensation of their CEOs not to other community-based nonprofits but to their for-profit publicly traded hospital CEO peers, who themselves are compared to leaders in the largest industrial and financial companies trading on Wall Street," the researchers said. "Since many boards set CEO salary by obtaining 'comparable' salary data, this becomes an ever-spiraling upward cycle."
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Amid the experiences of the COVID-19 pandemic, there is an opportunity for boards of nonprofit hospitals to rethink how their CEOs are paid, particularly compared to the staff at their facilities, representatives with the Lown Institute wrote in a Feb. 10 article published in Health Affairs.
The Lown Institute, a nonpartisan healthcare think tank, examined the gap between the pay of hospital staff and the CEO, as well as the implications of it.
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What are we rewarding hospital CEOs for -- and what metrics could drive their salaries on instead? In an recent piece in Health Affairs Forefront, Vikas Saini, Judith Garber, and Shannon Brownlee from the Lown Institute share findings from the Lown Hospitals Index on pay equity at nonprofit hospitals.
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MGB's continuing expansion raises questions about the underlying values of nonprofit hospitals. If you’re a hospital with tax-exempt status, “you could be asking, ‘what are you doing locally for the community?‘ ” Saini told me. “Or, you can figure out where there are paying customers and build a clinic.”
On one hand, MGB simply embodies the market-driven spirit of American health care: “They have to find revenue, and the revenue is fragmented in terms of geography and social class,” said Saini.
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Enjoy these Shkreli Award "dishonorable mentions" — nominees that didn't quite make the top ten, but are worth calling out nonetheless.
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A top ten list of the worst examples of profiteering and dysfunction in health care, named for Martin Shkreli, the price-hiking "pharma bro" that everyone loves to hate.
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A top ten list of the worst examples of profiteering and dysfunction in health care, named for Martin Shkreli, the price-hiking "pharma bro" that everyone loves to hate.
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