Does State Community Benefits Regulation Influence Charity Care and Operational Efficiency in U.S. Non-profit Hospitals?

Lamboy-Ruiz, Melvin A.; Cannon, James N.; Watanabe, Olena V.

doi:10.1007/s10551-017-3757-2

Cited by 18 publications

(11 citation statements)

References 36 publications

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“…The minimum community benefit requirement appears to be the one regulation associated with an increase in the likelihood of offering high eligibility limits for free and discounted care. Overall, the results are in line with previous studies that found that states with stricter tax-exempt rules and those in states that expanded Medicaid seem to be more generous in offering comprehensive community benefits [ 35 , 36 ].…”

Section: Discussionsupporting

confidence: 91%

A multilevel mixed-effects regression analysis of the association between hospital, community and state regulatory factors, and family income eligibility limits for free and discounted care among U.S. not-for-profit, 501(c)(3), hospitals, 2010 to 2017

Mose

2021

BMC Health Serv Res

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Background Not-for-profit hospitals are facing an uncertain financial future, especially following the COVID-19 pandemic. Nevertheless, they are legally obligated to provide free and discounted health care services to communities. This study investigates the hospital, community, and state regulatory factors and whether these factors are associated with family income eligibility levels for free and discounted care. Methods Data were sourced from Internal Revenue Service Form 990, several data files from the Centers for Medicare and Medicaid, demographic and community factors from the Census Bureau, supplemental files from The Hilltop Institute, Community Benefit Insight, and Kaiser Family Foundation. The study employs multilevel mixed-effects linear and ordered logit regressions to estimate the association between the hospital, community, state policies, and the hospital’s family income eligibility limit for free and discounted care. Results A plurality of hospitals (49.96%) offered a medium level of family income eligibility limit (160–200% of the federal poverty level (FPL)) for free care. In comparison, about 53% (52.94%) offered a low level (0–300 of FPL) eligibility limit for discounted care. Holding all else equal, hospitals designated as critical access, safety net, those in rural areas or located in disadvantaged areas were associated with an increased probability of offering low eligibility limits for free and discounted care. Hospitals in a joint venture, located in highly concentrated markets or states with minimum community benefits requirements, were associated with an increased probability of offering high eligibility limits. Conclusion State and community factors appear to be associated with the eligibility level for free and discounted care. Hospitals serving low-income or rural communities seem to offer the least relief. The federal and state policymakers might need to consider relief to these hospitals with a requirement for them to provide a specific set of minimum community benefits.

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Section: Discussionsupporting

confidence: 91%

A multilevel mixed-effects regression analysis of the association between hospital, community and state regulatory factors, and family income eligibility limits for free and discounted care among U.S. not-for-profit, 501(c)(3), hospitals, 2010 to 2017

Mose

2021

BMC Health Serv Res

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“…Meanwhile, there are many weaknesses in social organizations, which may lead partnerships in the production of public services to fail. Because social organizations are not profit-oriented, they have to use specific operational models and rely on multiple resource providers to implement their operations [ 29 ], such as exemption from paying taxes [ 30 ]. However, recent studies on the sustainability and accountability of social organizations have raised significant concerns that social organizations are philanthropic uncertainty (inadequacy of owned and attracted resources, or relying heavily on government funding), philanthropic particularism (focusing on particular client groups and geographical limiting), philanthropic distrust (abusing and misconducting of religious charity funds), philanthropic paternalism (influence of donors’ interests on the mission and perceiving the contribution to the organizations entitlement, not as a right), philanthropic amateurism (problems with attracting professional workers) [ 24 , 31 ].…”

Section: Literature Reviewmentioning

confidence: 99%

A SBM-DEA based performance evaluation and optimization for social organizations participating in community and home-based elderly care services

Shao

Yuan

Lin³

et al. 2021

PLoS ONE

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The community and home-based elderly care service system has been proved an effective pattern to mitigate the elderly care dilemma under the background of accelerating aging in China. In particular, the participation of social organizations in community and home-based elderly care service has powerfully fueled the multi-supply of elderly care. As the industry of the elderly care service is in the ascendant, the management lags behind, resulting in the waste of significant social resources. Therefore, performance evaluation is proposed to resolve this problem. However, a systematic framework for evaluating performance of community and home-based elderly care service centers (CECSCs) is absent. To overcome this limitation, the SBM-DEA model is introduced in this paper to evaluate the performance of CECSCs. 186 social organizations in Nanjing were employed as an empirical study to develop the systematic framework for performance evaluation. Through holistic analysis of previous studies and interviews with experts, a systematic framework with 33 indicators of six dimensions (i.e., financial management, hardware facilities, team building, service management, service object and organization construction) was developed. Then, Sensitivity Analysis is used to screen the direction of performance optimization and specific suggestions were put forward for government, industrial associations and CECSCs to implement. The empirical study shows the proposed framework using SBM-DEA and sensitivity analysis is viable for conducting performance evaluation and improvement of CECSCs, which is conducive to the sustainable development of CECSCs.

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“…Brammer and Millington (2004a) suggested that political stakeholders can constrain the activities of firms and managers by imposing strict regulations with regard to social and environmental costs, but also encourage firms through a favourable tax regime. Hospitals’ charity care is associated with state community benefit regulation in the United States (Lamboy‐Ruiz et al., 2019). Local political turnover implies potential policy change and creates opportunities for firms to win over new officials in competitive markets, such as firms using the change of city secretaries in China to shape social exchanges between firms and politicians (Jia & Zhang, 2018).…”

Section: Unpacking Placementioning

confidence: 99%

Place and corporate philanthropy: A systematic review

Mei

Wang

2021

Int J Management Reviews

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Place is omnipresent in corporate philanthropy, yet it is becoming paradoxically more and less salient at the same time. Viewing corporate philanthropy as a global yet localized phenomenon, current research is fraught with tension between sense of place and placelessness. To specify boundary conditions and add accuracy to our knowledge, we systematically review articles published in well‐regarded business and management journals and unearth the important role of place in corporate philanthropy. We show that place is manifested in a variety of forms, including geographic units, critical events and virtual platforms, and these manifestations are associated with firms’ experience of place as a social enclosure, political constellation and peer community. We find that place has three primary roles in affecting corporate philanthropy: socializing, rationalizing and learning. Our findings have significant implications for new scholarly directions that can extend our understanding of the place–corporate philanthropy nexus.

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Does State Community Benefits Regulation Influence Charity Care and Operational Efficiency in U.S. Non-profit Hospitals?

Cited by 18 publications

References 36 publications

A multilevel mixed-effects regression analysis of the association between hospital, community and state regulatory factors, and family income eligibility limits for free and discounted care among U.S. not-for-profit, 501(c)(3), hospitals, 2010 to 2017

A multilevel mixed-effects regression analysis of the association between hospital, community and state regulatory factors, and family income eligibility limits for free and discounted care among U.S. not-for-profit, 501(c)(3), hospitals, 2010 to 2017

A SBM-DEA based performance evaluation and optimization for social organizations participating in community and home-based elderly care services

Place and corporate philanthropy: A systematic review

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