Online Program

Community benefit and the Affordable Care Act: How will not-for-profit hospitals respond to change?

Tuesday, November 5, 2013

Henry Carretta, PhD MPH, Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallhassee, FL
Changes to IRS reporting for not-for-profit hospitals (NFPs) impose new requirements for reporting community benefit. The Affordable Care Act (ACA) requires NFPs to conduct Community Health Needs Assessments for their service area that incorporates input from local stakeholders, e.g. public health agencies. Concurrent changes in payment mechanisms and anticipated declines in the uninsured population pose new challenges to NFPs.

Study Design: Systematic review of peer reviewed literature, policy briefs, IRS documents, and components of the ACA related to NFP hospitals.

Findings: The formation of Accountable Care Organizations, payment reforms, and anticipated decline in the need for “charity care” has the potential to drastically change the completive environment in which NFPs operate. NFPs may need to rethink their mission and identify new ways to distinguish themselves from for-profit hospitals in order to justify their tax exempt status.

Conclusions: Changes in laws, regulations, and public expectations are apt to impose pressure on NFPs to undertake a new model of how they maintain their tax exempt status and their relationship to the population they serve.

Learning Areas:

Public health or related organizational policy, standards, or other guidelines
Public health or related public policy

Learning Objectives:
Describe IRS reporting requirements for provision of community benefit and components of the Affordable Care Act related to not-for-profit hospitals. Discuss how regulatory, environmental and completive pressures may influence the future mission of not-for-profit hospitals and create opportunities for partnerships with public health.

Keyword(s): Hospitals, Community Benefits

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investiagor on a RWJF grant to study community benefit. I am trained in organizational theory and have studied various aspects of hospitals for over 10 years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.