Question: A successful community benefit program of visiting older persons in their homes to manage their chronic lung problems results in fewer hospital admissions. Can the loss of revenue to the hospital be considered community benefit?
Recommendation: We recommend not counting the loss of revenue to the hospital as community benefit. The CHA community benefit guidelines explicitly recommend not counting as community benefit "opportunity costs" — for example the amount of revenue that could have been collected if this community benefit were not being provided. While this program is likely to be having a very positive impact on the community, establishing that it actually prevents admissions is very challenging without a rigorous evaluation. The cost of the program should be counted as community benefit, and the program could be highlighted in the narrative portion of the community benefit report.