title: Tax-exempt hospitals and community benefit: new directions in policy and practice.
abstract: The current community benefit standard for nonprofit hospital tax exemption has been the subject of mounting criticism. Many different constituencies have advanced the view that in its present form it fails to ensure that nonprofit hospitals provide adequate benefits to their communities in exchange for their tax exemption. In contrast, hospitals have often expressed the concern that the community benefit standard in its current form is vague and therefore difficult to comply with. Various suggestions have been made regarding how the existing community benefit standard could be improved or even replaced. In this article, we first discuss the historical and legal development of the community benefit standard. We then present the key controversies that have emerged in recent years and the policy responses attempted thus far. Finally, we evaluate possible future policy directions, which reform efforts could follow.
authors.affiliation: Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan 48109; email: rubind@umich.edu , singhsim@umich.edu.
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Rubin
authors.forename: Simone R
authors.initials: SR
authors.lastname: Singh
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Young
mesh_terms: D003159:Community-Institutional Relations / Q000191:economics; D003362:Cost-Benefit Analysis; D006291:Health Policy; D006788:Hospitals, Voluntary / Q000191:economics / Q000458:organization & administration; D006801:Humans; D019464:Tax Exemption / Q000191:economics / Q000331:legislation & jurisprudence; D014481:United States
keywords: IRS Form 990 Schedule H; Patient Protection and Affordable Care Act (PPACA); charity care; nonprofit hospitals; tax exemption