Not-for-profit hospitals are required to invest in health resources and programs, called community benefit, in exchange for millions of dollars in tax breaks. Because health is determined by factors outside a hospital or clinic’s walls, community benefit represents a pivotal opportunity to address the root cause of health disparities: Research consistently shows that a person’s zip code, not their genetic code, is the strongest predictor of health. However, not-for-profit hospitals still fail to maximize their community benefit programs to meet the needs of low-income and diverse communities.
California must improve community benefit standards and regulations in order to ensure that hospitals invest in services and resources that improve the most pressing concerns of marginalized communities across the state. The Affordable Care Act provided a clear opportunity to utilize community benefits to improve health and economic equity through strategic investments in affordable housing, quality jobs, environmental improvements, and other vital resources. Greenlining is a statewide leader in researching and advocating for policies that would ensure that community benefits respond to the needs of underserved communities of color.
The Health Equity team has published three reports that analyze the community benefit spending of hospitals across the state:
- Insufficient Data: Do Central Valley Not-For-Profit Hospitals Meet Their Community Benefit Obligations? (2016) – Our latest community benefit report analyzed spending of 11 not-for-profit hospitals across the San Joaquin Valley, and found that these large hospitals spent only 0.32 percent of their operating budgets on programs to improve the health of vulnerable populations. California’s Central Valley could benefit greatly from community benefits, but hospitals continue to ignore their potential to improve health and environmental conditions for disadvantaged populations.
- Community Benefit and Missed Opportunities: A Case Study of Three San Francisco Hospitals (2014) – This report took a close look at community benefit practices of San Francisco’s three largest not-for-profit hospitals. Our findings confirmed the disturbing lack of transparency and community engagement, originally raised in our first community benefit report.
- Not-For-Profit Hospitals and Community Benefit: What We Don’t Know Can Hurt Us (2013) – This report benchmarked the community benefit spending of the seven largest not-for-profit hospital systems across California. We identified several barriers to community benefits, such as legal loopholes and poor reporting, which made it difficult to determine the impact of community benefit dollars across the state.
Not-for-profit hospitals must align their community benefit investments with what low-income and diverse communities need to stay healthy. Investing in community health and prevention programs will save hospitals money and ensure that patients are less likely to be hospitalized or seek emergency care. As not-for-profit hospitals invest more community benefit dollars outside of the institution’s walls, communities stay healthier and come to see the value and leadership of their local hospital in keeping them healthy.