Hospital Community Benefits after the ACA: Addressing Social and Economic Factors that Shape Health

This issue brief continues the program's examination of state-level community benefit oversight by focusing on the ten states that require hospitals to develop implementation strategies: California, Illinois, Indiana, Maryland, New Hampshire, New York, Rhode Island, Texas, Vermont and Washington. It identifies specific social and economic factors that shape community health and are of great importance to state and local policymakers.

This brief begins by providing essential background information and describes the regulatory framework through which federal and state policymakers exercise oversight of hospital community benefits. Next, it describes current hospital-reported programs and initiatives that target specific social and economic factors, as reflected in more than 500 state-required implementation strategies—or reports of implementation strategies—as well as the methodology Hilltop employed in that review. This review provides a baseline of currently reported activities, many of which may have been initiated prior to enactment of the ACA.

The Hilltop Institute's Hospital Community Benefit Program is a central, objective resource for state and local decision makers who seek to ensure that tax-exempt hospital community benefit activities are responsive to pressing community health needs.