Montana health officials call out hospitals for too little charity : Shots

Montana health officials are seeking to increase oversight of nonprofit hospitals amid debate over whether they should pay them fairly. The proposal comes nine months after a KHN investigation found that some of Montana’s wealthiest hospitals, such as the Billings Clinic, lag behind state and national averages in community contributions.

Lynn Donaldson / Bloomberg via Getty Images

hide captions

switch captions

Lynn Donaldson / Bloomberg via Getty Images

Montana health officials are seeking to increase oversight of nonprofit hospitals amid debate over whether they should pay them fairly. The proposal comes nine months after a KHN investigation found that some of Montana’s wealthiest hospitals, such as the Billings Clinic, lag behind state and national averages in community contributions.

Lynn Donaldson / Bloomberg via Getty Images

Montana health officials are proposing to monitor and set standards for charitable donations that nonprofit hospitals make in their communities each year to justify their tax exemption every year. millions of dollars.

The proposal is part of a package of legislation that the state Department of Public Health and Human Services will ask lawmakers to pass when they convene in January. It came two years later state audit called on the ministry to play a more supervisory role and nine months later KHN investigates found that some of the wealthiest hospitals in Montana lag behind state and national averages in community contributions.

Call for more transparency on what counts as charity

Montana State Lotus. Bob KeenanOne Republican questioned whether nonprofit hospitals deserve their charitable status, calling the proposal a start that could be expanded later.

“Transparency is the name of the game here,” Keenan said.

IRS required nonprofit hospitals to tally the money they spend to “promote health” to benefit the “community at large”. How hospitals charge such contributions to justify their tax exemption is unclear and varies widely. National researchers studying the public interest have calls for tightening standards for what counts towards the request.

Montana is one of the most recent states to consider imposing new regulations or increasing oversight of nonprofit hospitals amid questions about whether they’re paying them fairly. Dr. Vikas Saini, president of the Lown National Institute for Healthcare Research, said that both at the state and local levels, people in California are learning whether to monitor the public interest of hospitals and enforce standards. new standard or not. Last year, Oregon has started a minimum amount that nonprofit hospitals have to spend for the public good. And Massachusetts updated guide to the public interest In recent years, there has been a push for hospitals to make more detailed assessments of how spending matches identified health needs.

Montana hospital industry officials say they want to work with the state to shape the proposed law, which they say the industry will support if it doesn’t conflict with federal rules. Saini said that to have an impact, any legislation would have to go beyond federal requirements.

Big tax breaks are at stake

In recent years, many, like Keenan and Saini, have questioned whether nonprofit hospitals are contributing enough to their communities to deserve the large tax breaks they receive while becoming into some of the biggest businesses in town.

“Hospitals are the backbone of the community, but people are starting to ask these questions,” says Saini.

Saini’s Institute evaluates hospital donations each year and finds that majority of nonprofit systems nationwide spend less on what the institute calls “meaningful” benefits than the estimated value of their tax relief. Actions the institute takes into account include financial assistance to patients and community investments such as food assistance, health education, or services provided at a loss, including addiction treatment.

The 2020 Montana audit found that hospitals in the state reported benefits vaguely and inconsistently, making it difficult to determine if their charity status was justifiable. However, state lawmakers did not address the issue during the biennial legislative session in 2021, and a Legislative Audit Division memo issued in June shows the health department The state has made “no meaningful progress” in developing nonprofit hospital philanthropic oversight since then.

KHN found that Montana’s nearly 50 nonprofit hospitals averaged only about 8% of their total annual costs into the public good for the tax year ending 2019. national average is 10%.

In some cases, hospitals’ coverage rates have dropped since then. For example, in the tax year ending 2019, Logan Health-Whitefish — a small hospital that is part of the larger Flathead Valley health system — reported that less than 2% of its total spending went to profits. community benefit. In its latest available documents, for the period ending 2021, the hospital reported spending 1% less on community benefits while earning $15 million more than spending level.

An alternative to surveillance?

Logan Health spokesperson Mellody Sharpton said the health system’s overall public benefit equates to nearly 9% of its spending, achieved across its six hospitals. It also has clinics throughout the valley. “It is important to consider the public interest of our organization as a whole,” says Sharpton, “when our facilities work together to ensure appropriate care is provided in the appropriate facility. to meet the health needs of the patient.”

State health officials have asked lawmakers to allow the agency to draft a bill that would give the health department explicit authority to require hospitals to submit annual reports that include data on community interest and charity care. The measure will also allow the department to develop standards for spending in the public interest, according to the department’s description of its proposal.

“We see a great need here to move the ball forward,” state health minister Charlie Brereton told lawmakers in August.

President of the Montana Hospital Association Rich Rasmussen said his organization wants to work with the health department on finalizing the legislation but says the definition of what counts as benefits should remain broad so hospitals can respond to pressing needs best of their region.

Furthermore, he said, hospitals have been working on their own reporting standards. This year, the association created a handbook for members and set a 2023 goal for hospitals to uniformly report their community interests, Rasmussen said. The association declined to provide a copy of the handbook, saying it will be made available to the public after hospitals receive training on how to use it later this fall.

The association also plans to create a website that will act as a one-stop shop for people who want to know how hospitals are reporting for the public good and addressing local health concerns. side, among other things.

Representative of the Republican Party. Jane Gillette said she supports increased oversight of the medical department and the idea behind the association’s website, but doesn’t think the hospital industry should produce that public resource alone. Gillette said she plans to introduce legislation that would require hospitals to report public interest data to a group outside the industry – such as the state – who would then post the information online.

Hospitals have resisted new regulations like this in the past

In the past, hospitals have resisted attempts to impose new rules on public benefit spending. In an interview with KHN last year, Jason Smith, then Bozeman Health’s director of promotion, said the system supports efforts to improve reporting contributions “beyond the new law”, and The time added that hospitals could function better without “state watchdogs being brought into the arena with us.”

Asked if the health system would still stand by that claim, Denise Juneau, Bozeman Health’s director of government and community affairs, said hospital officials hoped any new legislation would consistent with applicable federal guidelines. She said Bozeman Health will continue to work with the Montana Hospital Association to better identify and inform the public interest, with or without new legislation.

A lawmaker would have to backtrack on the state’s proposal by mid-December to keep it alive.

KHN (Kaiser Health News) is a national, editorially independent project of Kaiser . Family Foundation.

Source link


News7F: Update the world's latest breaking news online of the day, breaking news, politics, society today, international mainstream news .Updated news 24/7: Entertainment, the World everyday world. Hot news, images, video clips that are updated quickly and reliably

Related Articles

Back to top button