Not-for-profit vs for-profit hospitals in Metro Atlanta: Comparative analysis of tax status and community benefit.

详细信息   

• 作者：David ; John C.
• 学历：Doctor
• 年：2009
• 导师：Lindrooth, Richard,eadvisor
• 毕业院校：Medical University of South Carolina
• ISBN：9781109125436
• CBH：3356753
• Country：USA
• 语种：English
• FileSize：4593634
• Pages：149

文摘

Introduction. The study compared Community Benefit across not-for-profit and for-profit hospitals in the Atlanta Metropolitan Statistical Area MSA). The reason for choosing this market is due to availability of a good representative sample of both types of hospitals in this MSA, and being a resident of Georgia, I was interested to find out the behavior of the two types of hospitals. The importance of the project stems from: 1) Growing controversy and opinions about Community Benefit and how much not-for-profits should provide, above for-profits, to continue to enjoy tax exempt status. 2) Various tax exemptions in 2002 were estimated to be $12.6 billion according to Congressional Budget Office CBA. 2006). Federal and others equal half the share. The analysis of the data revealed that Appendix P1, P2, Q1, Q2 and Z): 1) Without tax components, not-for-profits provide a higher percent of net revenue as Community Benefit over the for-profits. 2) With federal, state and local taxes included, the for-profits did much better in Community Benefit provision. 3) A significant amount of federal, state, and property taxes are lost from not-for-profit hospitals, which can be used to provide more Community Benefits. Methods. Data Sources &amp； Analysis: a) Income statement components and cost/revenue components of the variables used in the calculation of Community Benefit were obtained from Medicare Cost Report. b) Tax rate components were obtained from corporate offices of the for-profits. c) Each hospitals Community Benefit component was calculated as a percent of net revenue and the overall Community Benefit was calculated. d) The study focused initially on 17 not-for-profit and 7 for-profit hospitals, in Atlanta Metropolitan Statistical Area MSA). e) The variables relating to Community Benefit were: patient revenue, margins, uncompensated care, and shortfalls in SCHIP, Medicaid, and Georgia Indigent Care Program GICP). f) The study expanded to include all the 27 not-for-profit and 9 for-profit hospitals. g) Both approaches grouped the hospitals into five revenue sizes and compared the Community Benefit of the two groups. h) Revenue sizes: 1) Under $100million, 2) $100million&ndash；under $250million, 3) $250 million&ndash；under $500million, 4) $500million&ndash；under $1billion, and 5) Over $1billion. Community Benefit Definition: 1) A planned, managed, organized, and measured approach to a health care organizations participation in meeting identified community health needs. 2) Of special significance is to benefit its residents&mdash；particularly the poor, minorities, and other underserved groups&mdash；by improving health status and quality of life CHA. 2006). Community Benefit meets at least one of the following criteria: 1) Generates a low or negative margin, 2) Responds to needs of special populations, such as minorities, frail elderly, poor persons with disabilities, the chronically mentally ill and persons with AIDS, and 3) The services or programs would likely be discontinued if the decision were made on a purely financial basis. Results Appendix P1, P2, Q1, Q2, and Z). In the first sample, using the selected hospitals, it was found that: 1) Without tax not-for-profits provided 7.67% average Community Benefit and for-profits, 5.83%； a difference of -1.84% in favor of the not-for-profits . 2) With tax of 4.8%, not-for-profits provided the same 7.67% while the for-profit share increased to 10.63% a ＋2.96% difference in favor of the for-profits. 3) Factoring negative income and margins Appendix P &amp； Q), and at 2.74% tax rate for-profit share declined to 8.57% a ＋0.90% difference in favor of the for-profits. In the second sample, including all the hospitals, the following results were found: 1) Not-for-profits provided reduced Community Benefit of 6.60% in comparison to 5.63% provided by for-profits, a difference of -0.97% in favor of not-for-profits . 2) With tax rate of 4.8, not-for-profits provided the same 6.60% while the for-profit share increased to 10.43%, a ＋3.83% difference in favor of the for-profits. 3) Factoring negative income and margins Appendix P &amp； Q), and at 2.74% tax rate for-profit share declined to 8.37% a ＋1.77% difference in favor of the for-profits. Abstract shortened by UMI.).