Tax-exempt Hospitals Provided Nearly $150 Billion in Total Benefits to Their Communities

WASHINGTON (September 10, 2025) – All of America’s hospitals, regardless of ownership status, continue to provide a comprehensive range of benefits, programs and essential services to their communities despite a range of challenging headwinds, including workforce pressures, rising costs of providing care and federal spending reductions. Nonprofit hospitals, which make up a majority of U.S. community hospitals, are required by law to identify the range of challenges faced by their communities through input from residents, support community programs and services aimed at addressing these issues, and publicly report data on these community investments.

New analysis released today by the American Hospital Association (AHA) shows that tax-exempt hospitals provided nearly $150 billion in total benefits to their communities in 2022 alone; the most recent year for which comprehensive data is available from the Internal Revenue Service.

This represents a nearly 50% increase in community benefit spending over five years from 2017 to 2022. A large portion of these benefits — representing nearly 7% of nonprofit hospitals’ total expenses, or approximately $65 billion — was for financial assistance for patients in need, including absorbing underpayments from Medicaid, CHIP and other federal, state, or local government programs for the low-income. Tax-exempt hospitals’ and health systems’ total community benefits were 15.1% of their total expenses in 2022.

“This report reaffirms that improving the health of their communities is at the heart of every hospital and health system’s mission,” said AHA President and CEO Rick Pollack. “In the face of a number of obstacles that pressure our health care system and caregivers, the hospital field has doubled down on our commitment to expanding care outside the four walls of the hospital and advancing health in the communities we proudly serve.”

A 2024 report from the accounting firm EY demonstrated that for every dollar invested in nonprofit hospitals and health systems through the federal tax exemption, $10 in benefits was delivered back to communities, illustrating the tremendous return that those communities receive.

Hospitals are committed to serving their communities in a variety of important ways and report a wide range of community benefit activities, including financial assistance for those in need. In addition, hospitals and health systems benefit communities by:

• Underwriting education, research and training for the next generation of caregivers.
• Subsidizing many high-cost essential services such as trauma care and behavioral health.
• Operating clinics for underserved communities and delivering a wide range of programs and services designed to meet the current and future health needs of the communities they serve.
• Absorbing bad debt expense, which is when hospitals cannot obtain reimbursement from patients for care provided.

Hospitals also strive to ensure that low-income patients have regular access to care through programs like Medicaid and Medicare. This commitment requires hospitals to absorb the financial shortfall when payments from public insurance programs do not fully cover the cost of providing care, which they often do not. In fact, hospitals absorbed $130 billion in underpayments from Medicare and Medicaid in 2023 alone. These shortfalls are worsening — growing on average 14% annually between 2019 and 2023.

View the full analysis or see more information on how the hospital field is benefiting their communities.