Hospital Community Benefit Regulations And Empirical Study Of The United States

Since the emergence of modern hospitals,the hospital community benefit has been a concern.In the study of hospital community benefit,America has always been at the forefront.Actually,the not-for-profit hospital is the most common type of medical profession in the United States,which provides nearly 70%health care for patients.The Internal Revenue Service regulates that if one not-for-profit hospital wants to get or maintain federal tax exemption,it must assume community benefit.With the added attention to not-for-profit hospitals to fulfill community benefit,some industry organizations also raise their community benefit requirements.In addition,only 7 states in the United States don’t establish their community benefit requirements.In fact,with the development of health care reform,the practice of hospital community benefit is steadily advancing in the United States.Objectives:This paper is intended to compare the hospital community benefit standards/guidelines in defining community benefit between two government agencies(IRS,CMS)and four industry organizations(AHA,CHA/VHA,HFMA).At the same time,we determine the community benefit guidelines issued by CHA/VHA as the federal representative,then we compare it with the hospital community benefit standards from 15 representative states in order to grasp the differences between them.Furthermore,based on the community benefit annual report from 2004-2013 fiscal year,we analyze the community benefit practice of Maryland.Methods:Through reading literature,visiting the related sites,we collect information about hospital community benefit standards/guidelines from IRS,CMS,AHA,CHA/VHA,HFMA and 15 representative states.With the use of comparative method,we evaluate the similarities and differences in hospital community benefit definitions between federal and states.In addition,we analyze the community benefit practice of Maryland by Excel software.Conclusions:Among the standards and guidelines from IRS、AHA、CHA/VHA、HFMA and 15 representative states,consensus exists to define charity care,the unreimbursed cost of Medicaid.However,consensus does not exist to define bad debt and the unreimbursed cost of Medicare as community benefit.According to the analysis of Maryland,we found that the hospital community benefit practice of the state maintain a good posture,but in the measurement of the net community benefit expense,the state has defects.