Nonprofit Hospital Community Benefits: The Effect of Needs Assessment Quality and Monetary Input on Health Outcomes.

Nonprofit hospitals in the United States are expected to give back to their communities and promote healthy living. In return for providing community services they are recognized as charity organizations and awarded tax exempt status. Concerns that nonprofit hospitals have not fulfilled this expectation have resulted in regulation policies on state and federal levels. Most attempts to quantify community contributions have focused on input-based (monetary) measures. An outcomes-based approach is more desirable for assessing whether the services provided by nonprofits are benefiting their communities. The Affordable Care Act of 2010 introduced new regulations in an attempt to pave the way for quantitative outcome-based measures. Hospitals are now required to perform assessments of their communities and design implementation strategies to address community needs. In this study, I introduce an outcomes-based approach for evaluating the effectiveness of these community assessments and implementation strategies at certain nonprofit Texas hospitals. Using composite Prevention Quality Indicators for these hospitals, I examine if rates of certain preventable health conditions can be linked to a nonprofit hospital’s monetary input towards community benefits and to qualitative scores assigned to their community health needs assessments.