AUTHOR=Barnett Kevin 

TITLE=Community Benefit: Policies, Practices, and Opportunities at the Half-Century Mark

JOURNAL=Frontiers in Public Health

VOLUME=Volume 8 - 2020

YEAR=2020

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2020.00289

DOI=10.3389/fpubh.2020.00289

ISSN=2296-2565

ABSTRACT=The half century since the expansion in the legal definition of charity for tax-exempt hospitals has been marked by periodic regulatory actions at the municipal, state, and federal level to quantify their contributions in a manner that justify the deferral of tax revenues.  The movement towards risk-based reimbursement in the last decade creates an incentive for a shift in hospital leadership understanding and approach to community benefit programs and services.  The historical interpretation of community benefit as an issue of legal compliance is being supplanted by a recognition that strategic resource allocation offers the potential to reduce financial risk associated with preventable emergency room and inpatient utilization.   This article reviews the evolution of state policies upon community benefit practices.  It also examines the importance of increased availability and strategic use of data on health care costs, mapping of health care utilization patterns, and parallel overlays of hospital location, jurisdictional boundaries, and the social determinants of health to inform public dialogue at the regional level and build an ethic of shared ownership for health across sectors.  Local public health agencies have the potential to play an important role in a regional approach to health improvement that better aligns and focuses the assets of health, community development, and business sector stakeholders to address the drivers of poor health in communities where health inequities are concentrated.