States' hospital associations share charity care numbers

As nonprofit hospitals and health systems are feeling more pressure to prove that they are providing charitable benefits to the communities they serve, state hospital associations are increasingly helping them spread the word about how much they are investing in such endeavors.

The Missouri Hospital Assn. on May 18 became the latest association to release a report detailing how much hospitals in that state spend on charity care and other benefits. Associations in Michigan, Nebraska and Ohio have released similar reports, and one is in the works in Wisconsin. Others may be available as well.

The Missouri report shows how much each hospital spent on several categories including charity care, uncompensated bad debt and education based on information from fiscal year 2004. Mary Becker, a senior vice president with the association, said about 125 out of the state's 141 hospitals participated in the volunteer survey.

Increased scrutiny of whether nonprofit hospitals deserve tax exemptions, as well as the push for pricing transparency created by the consumer-driven health care movement could be among several factors that are causing hospitals to raise the profile of this type of information, Becker said. "But as much of a factor is the realization among hospitals that they have a story to tell," she said.

That story could be a great public relations tool, said Mary Kay Grasmick, a spokeswoman for the Wisconsin Hospital Assn. "An important aspect of public relations is to take the programs and services that the departments have been doing and collect them and then report on what you're doing," she said.

Grasmick said her organization launched a survey in January to track charity care at the state's 131 acute-care hospitals. Results will be posted on a Web site sometime this fall.

Different measures and categories may appear on the different state reports. Laura Clay Trueman, executive director of the Washington, D.C.-based Coalition for Affordable Health Coverage, which includes the AMAas a member, said it could be helpful to learn about what hospitals are spending on community benefits, but if that is reported using different methods, it won't be as useful.

"If there's not a consistent standard of how you share that information, it does complicate how we can understand it and get a good, clear picture of what hospitals are doing in this area," she said.

The American Hospital Assn. does not offer a hospital-by-hospital breakdown of the figures nationwide. In a report issued in 2005, however, the organization said uncompensated care at the nation's community hospitals had risen from $3.9 billion in 1980 to $26.9 billion in 2004.