Improving Community Health through Hospital Community Benefit Spending: Charting a Path to Reform

Abstract

A new report recommends that the Trump administration take action to revise existing Internal Revenue Service policies governing community benefit spending by tax-exempt hospitals in order to encourage greater hospital involvement in activities that can improve health on a community-wide basis.Research increasingly shows the outsize importance of healthy communities to population health. Affordable and safe housing, safe and welcoming neighborhoods, access to nutritious food, strong child development programs and quality education together can lead to better health outcomes. Hospitals themselves have recognized the health impact of these broader social, economic and environmental conditions and as well as the value of their involvement in activities aimed at improving social conditions.Building on longstanding policies regarding tax exempt hospitals and community benefit spending, the report shows the incoming Trump administration can encourage greater hospital involvement in community-wide health by adopting a more flexible regulatory standard on what constitutes a community benefit. Produced by researchers at the George Washington University's Milken Institute School of Public Health (Milken Institute SPH), the report identifies a series of steps that the IRS can take, working in collaboration with public health experts drawn from across government and private institutions and organizations, to modify existing community benefit policies to encourage greater population health activities. Such a change would be wholly consistent with hospitals' own community health needs assessments (CHNAs), which focus on high-priority community health needs that extend beyond clinical health care

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