Community Benefit

About Community Benefit

About Community Benefit

Not-for-profit health care organizations demonstrate their commitment to community service through organized and sustainable community benefit programs providing:

  • Free and discounted care to those unable to afford health care.
  • Care to low-income beneficiaries of Medicaid and other indigent care programs.
  • Services designed to improve community health and increase access to health care.

Community benefit is also the basis of the tax-exemption of not-for-profit hospitals. The Internal Revenue Service (IRS), in its Revenue Ruling 69–545, describes the community benefit standard for charitable tax-exempt hospitals. Since 2008, tax-exempt hospitals have been required to report their community benefit and other information related to tax-exemption on the IRS Form 990 Schedule H.

The Affordable Care Act, passed in 2010, added new requirements for tax-exempt hospitals regarding:

  • Community health needs assessment and planning.
  • Financial assistance.
  • Charges.
  • Billing and collections.

Community Benefit Videos

Visit our YouTube channel to hear CHA's senior director for continuing care ministries, Julie Trocchio, answer questions about community benefit and to view a Community Benefit Reflection.

Videos include:

What Are Community Benefits?

Community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. They increase access to health care and improve community health.
A community benefit must respond to an identified community need and meet at least one of the following criteria:

  • Improve access to health care services.
  • Enhance health of the community.
  • Advance medical or health knowledge.
  • Relieve or reduce the burden of government or other community efforts.

A program or activity should not be reported as community benefit if it is:

  • Provided for marketing purposes.
  • Restricted to hospital employees and physicians.
  • Required of all health care providers by rules or standards.
  • Questionable as to whether it should be reported.
  • Unrelated to health or the mission of the organization.

How do health care organizations provide community benefits?

The Catholic Health Association recommends that health care organizations implement a comprehensive framework for planning, delivering and reporting their community benefit efforts. This framework includes the following elements:

  • Build a sustainable infrastructure — Create a culture that supports the organization's community benefit mission and put in place operational elements that sustain community benefit programs such as qualified staff, sufficient budgets, and supportive policies and procedures.
  • Plan for community benefit — Work with public health experts and community partners to assess and prioritize community health needs and develop programs based on goals, measurable outcomes and evidence-based interventions.
  • Account for community benefit — Adopt standardized principles and practices to account for community benefit and establish effective administrative and accounting processes to accurately account for and report community benefit to various stakeholders, including the IRS and state/local agencies.
  • Evaluate community benefit programs — Assess the quality and effectiveness of the overall program and individual programs and activities.
  • Tell the community benefit story — Report the organization's community benefit efforts as required to regulatory bodies (such as the IRS or state/local agencies) and to communities and other important constituencies such as hospital staff, physicians and donors.

What are trends in community benefits?

  • Hospital community benefit programs are increasingly accountable to their communities, boards, employees and to organizations granting tax-exemption.
  • Community benefit programs are more public health oriented, using tools and expertise from professional and academic public health.
  • Most community benefit programs strategically focus on a few issues where they are likely to make an impact rather than scattering scarce resources on multiple "random act of kindness."
  • While community benefit programs of the past tended to be planned and carried out by the hospital itself, today's community benefit programs work with a wide range of community partners to improve community health and increase access to services.