Report: Calif. Hospitals Do Not Spend Enough on Community Benefits
Several California hospitals do not spend enough on so-called "upstream" benefits, or proactive efforts, to prevent illnesses in the community, according to a study by the Greenlining Institute, Payers & Providers reports.
Findings
The study estimated that state hospitals often devoted less than 10% of their community benefits budget on such efforts, with the state's largest hospitals:
- Allocating less than 7.2% of their operating budgets on community benefits; and
- Spending less than 1.1% of community benefits funding on upstream benefits.
For example, the study found that:
- Kaiser Permanente in 2009 exploited an Internal Revenue Service ruling by spending three times more on research and health professional education than community benefits; and
- Sutter Coast Hospital in Northern California reported a "negative community benefit," meaning that it provided no tangible benefits for the community other than charity care.
The study also found that reporting on community benefits spending varied across the state.
Recommendations
Greenlining recommended that:
- State lawmakers pass legislation to provide greater clarity to community benefits reporting laws;
- Gov. Jerry Brown (D) and state Health and Human Services Agency Secretary Diana Dooley offer more financial support to the Office of Statewide Health Planning and Development to increase reporting accountability; and
- Community members have a say in how providers conduct community health assessments.
CHA's Reaction
In a release, the California Hospital Association said Greenlining's report "relies on inaccuracies and faulty assumptions to criticize a program that is, in fact, a robust, effective, transparent partnership between the state's not-for-profit hospitals and the communities they serve."
CHA President C. Duane Dauner said Greenlining's push to have more funding allocated to community benefits "fails to recognize the financial pressures, unfunded governmental mandates ... and delivery system changes that are challenging hospitals like never before."
Dauner added, "Local residents, stakeholders and hospitals all will be better served if they determine their local health care and communities' priorities together, rather than facing another mandate from Sacramento" (Shinkman, Payers & Providers, 11/21).
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