Charity Care Characteristics and Expenditures Among US Tax-Exempt Hospitals in 2016

2020 ◽  
Vol 110 (4) ◽  
pp. 492-498 ◽  
Author(s):  
Christopher W. Goodman ◽  
Amber Flanigan ◽  
Janice C. Probst ◽  
Allan S. Brett
Keyword(s):  
Affordable Care Act ◽  
Web Sites ◽  
Health Care Services ◽  
Internal Revenue Service ◽  
Charity Care ◽  
Community Benefit ◽  
Care Services ◽  
Tax Exempt ◽  
Potential Benefits ◽  
Eligibility Requirements

Objectives. To examine content of financial assistance polices (FAPs) among US tax-exempt hospitals and determine whether restrictive policies were associated with reduced charity care spending. Methods. Using hospital tax filings with the Internal Revenue Service in 2016 and FAPs obtained from hospital Web sites, we examined characteristics of FAPs and associated expenditures for charity care in a representative sample of 170 tax-exempt hospitals. We identified common eligibility requirements and used them to define restrictiveness of FAPs. Results. FAPs were characterized by various ways to exclude patients, a patchwork of coverage for typical health care services, and wide-ranging discounts. FAP expenditures were lowest among restrictive hospitals in states that expanded Medicaid as part of the Affordable Care Act and highest among nonrestrictive hospitals in nonexpansion states. FAP expenses did not differ by hospital restrictiveness alone. Conclusions. Standardizing common eligibility requirements among FAPs carries potential benefits with regard to optimizing charity care for community benefit and achieving at least some level of equity; however, further policy efforts must account for additional restrictions, charges, and exclusions to be effective.

Linking Cost Control Measures to Health Care Services by Using Activity-Based Information

1995 ◽  
Vol 8 (4) ◽  
pp. 221-233 ◽  
Author(s):  
Ronald E. Hoyt ◽  
Colin M. Lay
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
New Technology ◽  
Control Measures ◽  
Patient Treatment ◽  
Management Information ◽  
Care Services ◽  
Potential Benefits ◽  
Cost Variability ◽  
The Impact

Canada's health care institutions are under pressure to limit expenditures, maintain or increase productivity, and assimilate new technology. Even though more than 75% of hospital operating expenditures are controllable, according to a study by the Economic Council of Canada, cost systems are needed to provide essential management information. The new Canadian Management Information System (MIS) Guidelines for health care are designed to provide accurate cost measurement of patient treatment and to help managers evaluate the impact of planned program changes on areas of operational responsibility. Other potential benefits of implementing the MIS guidelines include correcting dysfunctional funding of health care units with benchmarking and setting high reporting standards for resource use at the patient level (MIS, 1991). This paper focuses on one important aspect of bringing these costs under control by examining the relation between cost deviations (variances) and underlying cost drivers. Our discussion will lead to the conclusion that incompatibility of DRG methodology and traditional cost accounting models may be an important source of cost variability within diagnostically-related disease groupings.

… And Health Care for All: Immigrants in the Shadow of the Promise of Universal Health Care

2009 ◽  
Vol 35 (1) ◽  
pp. 185-204 ◽  
Author(s):  
Adrianne Ortega
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care Services ◽  
Insurance Coverage ◽  
The United States ◽  
Care Plan ◽  
Universal Health Care ◽  
Care Services ◽  
Eligibility Requirements ◽  
Universal Health

President Obama’s ambitious universal health care plan aims to provide affordable and accessible health care for all. The plan to cover the estimated 46.5 million uninsured, however, ignores the over thirty million non-citizens living in the United States. If the United States passes universal health care coverage, Congress should repeal the prohibitions of the Welfare Reform Act, extend Medicaid coverage to non-citizens, and allow non-citizens to purchase employer-based insurance coverage.President Obama’s plan follows the lead of state universal health care legislation by retaining private, employer-sponsored insurance coverage and expanding the eligibility requirements of the Medicaid program. This strategy will not aid uninsured immigrants or overburdened states and hospitals, though, because current law excludes most non-citizens from nonemergency health care services.

scholarly journals The Patient Protection and Affordable Care Act and Utilization of Preventive Health Care Services

SAGE Open ◽  
2016 ◽  
Vol 6 (1) ◽  
pp. 215824401663618
Author(s):  
Victor Eno ◽  
Senthilkumar Mehalingam ◽  
Thomas I. Nathaniel
Keyword(s):  
Health Care ◽  
Affordable Care Act ◽  
Health Care Services ◽  
Preventive Health Care ◽  
Preventive Health ◽  
Care Services ◽  
Patient Protection

scholarly journals Family Planning Programs for the 21st Century: Rationale and Design

2012 ◽  
Keyword(s):  
Family Planning ◽  
Health Care Services ◽  
Large Scale ◽  
Modern Method ◽  
The Past ◽  
Care Services ◽  
Development Interventions ◽  
Family Planning Programs ◽  
Potential Benefits ◽  
And Child Health

Family planning improves health, reduces poverty, and empowers women. Yet, today, more than 200 million women in the developing world want to avoid pregnancy but are not using a modern method of contraception. They face many obstacles, including lack of access to information and health-care services, opposition from their husbands and communities, misperceptions about side effects, and cost. Family planning programs are among the most successful development interventions of the past 50 years. They are unique in their range of potential benefits, encompassing economic development, maternal and child health, educational advances, and women’s empowerment. Research shows that with high-quality voluntary family planning programs, governments are able to reduce fertility and produce large-scale improvements in health, wealth, human rights, and education. This book is a comprehensive resource for policymakers and donors. It makes the case for increased funding and support of voluntary family planning, and details how to design programs to operate both ethically and effectively.

scholarly journals The impact of the Affordable Care Act on patient coverage and access to care: perspectives from FQHC administrators in Arizona, California and Texas

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Angelo Ercia
Keyword(s):  
Access To Care ◽  
Affordable Care Act ◽  
Health Care Services ◽  
Healthcare Services ◽  
Structured Interviews ◽  
Care Services ◽  
Healthcare Needs ◽  
The Affordable Care Act ◽  
Insured Patients ◽  
The Impact

Abstract Background The Affordable Care Act (ACA) enabled millions of people to gain coverage that was expected to improve access to healthcare services. However, it is unclear the extent of the policy’s impact on Federally Qualified Health Centers (FQHC) and the patients they served. This study sought to understand FQHC administrators’ views on the ACA’s impact on their patient population and organization. It specifically explores FQHC administrators’ perspective on 1) patients’ experience with gaining coverage 2) their ability to meet patients’ healthcare needs. Methods Twenty-two semi-structured interviews were conducted with administrators from FQHCs in urban counties in 2 Medicaid-expanded states (Arizona and California) and 1 non-expanded state (Texas). An inductive thematic analysis approach was used to analyze the interview data. Results All FQHC administrators reported uninsured patients were more likely to gain coverage from Medicaid than from private health insurance. Insured patients generally experienced an improvement in accessing healthcare services but depended on their plan’s covered services, FQHCs’ capacity to meet demand, and specialist providers’ willingness to accept their coverage type. Conclusion Gaining coverage helped improved newly insured patients’ access to care, but limitations remained. Additional policies are required to better address the gaps in the depth of covered services in Medicaid and the most affordable PHI plans and capacity of providers to meet demand to ensure beneficiaries can fully access the health care services they need.

Following the Money

2020 ◽  
Vol 48 (3) ◽  
pp. 434-442 ◽  
Author(s):  
William M. Sage ◽  
Timothy M. Westmoreland
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Health Insurance ◽  
Affordable Care Act ◽  
Health Care Services ◽  
Future Health ◽  
Care Services ◽  
Policies And Procedures ◽  
Future Health Care ◽  
Health Returns

It is no exaggeration to say that American health policy is frequently subordinated to budgetary policies and procedures. The Affordable Care Act (ACA) was undeniably ambitious, reaching health care services and underlying health as well as health insurance. Yet fiscal politics determined the ACA’s design and guided its implementation, as well as sometimes assisting and sometimes constraining efforts to repeal or replace it. In particular, the ACA’s vulnerability to litigation has been the price its drafters paid in exchange for fiscal-political acceptability. Future health care reformers should consider whether the nation is well served by perpetuating such an artificial relationship between financial commitments and health returns.

Comparison of Trends in Nonprofit Hospitals’ Charity Care Eligibility Policies Between Medicaid Expansion States and Medicaid Nonexpansion States

2021 ◽  
pp. 107755872110396
Author(s):  
Ge Bai ◽  
Hossein Zare ◽  
Matthew D. Eisenberg ◽  
Daniel Polsky ◽  
Gerard F. Anderson
Keyword(s):  
Affordable Care Act ◽  
Medicaid Expansion ◽  
Care Provision ◽  
Policy Changes ◽  
Charity Care ◽  
Nonprofit Hospitals ◽  
Medicaid Coverage ◽  
Longitudinal Trend ◽  
Tax Exempt ◽  
The Affordable Care Act

Nonprofit hospitals provide charity care to financially disadvantaged patients according to their self-designed eligibility policies. The Affordable Care Act may have prompted nonprofit hospitals to adopt more generous eligibility policies, but no prior research has examined the longitudinal trend. The expansion of Medicaid coverage in many states has been found to reduce charity care provision, but it is unclear whether the change in charity care eligibility policies differed between Medicaid expansion and nonexpansion states. Using mandatory tax filings, we found that both hospitals in Medicaid expansion states and hospital in nonexpansion states adopted more generous eligibility policies in 2018 than in 2010, but the change was greater in the former for discounted charity care; while the former provided less charity care regardless of their policy changes, the latter provided more when their policies became more generous. This study has implications for policy discussions on the justification of nonprofit hospitals’ tax-exempt status.

Stabilizing and Strengthening the Affordable Care Act: Opportunities for a New Administration

2021 ◽  
Author(s):  
Stacey McMorrow
Keyword(s):  
Health Care ◽  
Affordable Care Act ◽  
Health Care Access ◽  
Health Care Services ◽  
Federal Law ◽  
The Past ◽  
Care Access ◽  
Care Services ◽  
The Affordable Care Act ◽  
The Law

Abstract Over the past decade, the Affordable Care Act (ACA) has successfully reduced uninsurance and improved access to and affordability of health care services for millions of Americans. But the law has been weakened over the past four years as the Trump administration shortened the open enrollment period in the federal Marketplace, reduced outreach and enrollment funding, and revised the public charge rule, among other actions. The incoming Biden administration will have the chance to reverse some of these changes and further strengthen the law to improve health care access and affordability. In this paper, I explore options to expand access to affordable coverage and care for those who do not qualify for Medicaid or Marketplace financial assistance, and further discuss opportunities to increase enrollment among those who are already eligible. I also examine opportunities to expand access to specific services, including reproductive health care, among those with insurance. Any attempts to modify or build upon the ACA will likely be complicated by the ongoing coronavirus pandemic as well as a divided Congress, but regulatory solutions will likely be easier to achieve than those that require changes to federal law or state policy.

The Accountability of Nonprofit Hospitals: Lessons from Maryland's Community Benefit Reporting Requirements

2009 ◽  
Vol 46 (2) ◽  
pp. 122-139 ◽  
Author(s):  
Bradford H. Gray ◽  
Mark Schlesinger
Keyword(s):  
Data Capture ◽  
Internal Revenue Service ◽  
Charity Care ◽  
Nonprofit Hospitals ◽  
Community Benefit ◽  
Internal Revenue ◽  
Reporting Requirements ◽  
New Community

Under Internal Revenue Service requirements, nonprofit hospitals will begin filing new community benefit reports in 2010. Maryland has had similar requirements since 2004. This paper, based on interviews at 20 hospitals, describes how Maryland's requirements affected hospitals and their activities. Increases in reported community benefit expenditures since the program began are due to both changes in activities and better data capture. Charity care accounts for one-third of community benefit dollars. A key distinction concerns whether hospitals take an accounting or managerial approach to community benefit. The Maryland experience suggests the issues that will arise when the national requirements are implemented.

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