"There's been an assumption that these hospitals that don't pay taxes are spared the taxes because they provide a community benefit," said Dr. Vikas Saini, president of the Lown Institute.
The institute's analysis shows that is not necessarily the case, Saini said. Nearly three-quarters of private nonprofit hospitals nationwide spent less on community benefits than they received in tax breaks. That translated into a total deficit of $17 billion.
The rate was even higher in New York City, where 33 of 40 private hospitals spent less than they got in tax breaks, the institute's analysis found.
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Lown calculated a total fair share deficit of $17 billion in 2018, the latest year for which tax forms were available. Individual hospital deficits ranged from a few thousand dollars to $261 million at Cleveland Clinic's main campus.
"What we're finding is, based on the dollar benefit of the non-profit status, there are a lot of hospitals that really aren't meeting that social contract, if you will," said Dr. Vikas Saini, president of the Lown Institute, a nonpartisan think tank focused on healthcare cost, quality and equity issues.
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Overtreatment and low-value care may cost more than $100 billion per year. In the new Back Surgery (Spinal Fusion) rating, we incorporate a measure of overuse that was calculated for U.S. News by data scientists at the Lown Institute, a nonpartisan think tank. This measure is also a component of the Overuse metric of the Lown Institute Hospitals Index. Because a pattern of overuse or low-value care is not compatible with being a high-quality provider, U.S. News will explore additional opportunities to incorporate measures of value in future editions of Best Hospitals.
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What the study found was that major U.S. cities, including Philadelphia, have some of the most racially segregated hospitals in the country. And many metropolitan areas have a high proportion of hospitals at each end of the inclusivity rankings (most inclusive versus least inclusive).
“Typically what we see is that some ZIP codes contribute a lot more to a hospital or other ZIP codes inside that perimeter contribute far fewer,” said Saini. “Some ZIP codes contribute none at all.”
One of the goals of the Lown Institute’s Hospital Index is to invite stakeholders to create a health care system that doesn’t look so segregated, Saini said, “where people go where they go because they made a choice. [Where] it’s not just about their income or their insurance or the color of their skin or the neighborhood they live in. And we’re a long way from that.”
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