A Comparison of Nonprofit Hospital Charity Care Policies and Community Benefit in Central Ohio to Peer Cities

Background: Nonprofit hospitals in the United States are required to provide community benefits, including charity care, to receive tax exemption from the federal government. Central Ohio's nonprofit hospitals have agreed to the same charity care policies, which may be unique compared to other communities across the county. The aim of this research is to compare the charity care policies of hospitals in Columbus, Ohio, to their peer cities, investigating if hospitals in similar cities have common shared charity care thresholds and to determine if hospitals in peer cities provided similar levels of community benefit. Methods: Tax data from nonprofit hospitals in 21 cities were collected and analyzed using Microsoft Excel (Microsoft Corporation). City community benefit data was summed and averaged using Excel to create a graphical representation of the data. Results: Only Columbus, Ohio, and Providence, Rhode Island, reported the same charity care thresholds across hospitals. Data demonstrate that Columbus provides less community benefit in dollars to total expenses compared to peer cities; however, this appears to be only true regarding other community benefit excluding charity care. Columbus was near the median among cities examined in regard to percentage of charity care to total community benefit. Conclusion: Results suggest variability in the amount and type of community benefit nonprofit hospitals provide. Central Ohio hospitals have the same charity care thresholds and spent approximately the same in total community benefit however it is not transparent how these funds are utilized. Current federal regulations do not assess whether the community benefits reported are affecting community health outcomes.