Tag Archives: IRS

New site gives access to nonprofit hospital financial data

Len Bruzzese

About Len Bruzzese

Len Bruzzese is the executive director of AHCJ and its Center for Excellence in Health Care Journalism. He also is an associate professor at the Missouri School of Journalism and served for nearly 20 years in daily journalism.

The Association of Health Care Journalists today unveiled hospitalfinances.org, a website that offers free, searchable financial information on nonprofit hospitals across the United States.

The aim is to make nonprofit hospital finances easier to access, search and analyze. This effort follows years of training by AHCJ to encourage journalists and the public to use nonprofit hospital filings and learn more about hospitals. Continue reading

Proposed rule change aims at making family dental coverage more affordable

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health and the author of "Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America." She can be reached at mary@healthjournalism.org.

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Photo: Melissa Clark via Flickr

Oral health advocates are applauding a recently proposed federal rule they say would remove a significant financial barrier many parents face when shopping for affordable dental benefits for their children on health insurance marketplaces.

A rule change filed last month by the Internal Revenue Service (IRS) would adjust how premium tax credits are calculated to better ensure the credits can apply to stand-alone pediatric dental coverage purchased on exchanges. Continue reading

Health reform comes with new rules for nonprofit hospitals

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org. Follow her on Facebook.

When I first started covering health care, I thought that a nonprofit hospital was one that didn’t make any money. It took longer than I should probably admit to come to understand that nonprofit/nonprofit status isn’t about making money. It’s mostly about paying taxes.

As this excellent recent story by M.B. Pell in The Atlanta Journal- Constitution shows, nonprofits may or may not have a healthy bottom line. They may or may not pay their top executives a lot of money. They may or may not provide really good care.

What questions do you have about health reform and how to cover it?

Joanne KenenJoanne Kenen is AHCJ’s health reform topic leader. She is writing blog posts, tip sheets, articles and gathering resources to help our members cover the complex implementation of health reform. If you have questions or suggestions for future resources on the topic, please send them to joanne@healthjournalism.org.

What they don’t do is pay taxes. Nonprofits are supposed to be mission-driven. In exchange for serving their community, they get the tax exemption.

One little-known element of the health care reform law – which I highlighted in my first tip sheet on the anniversary of the law’s passage – sets new rules for nonprofits. They are required to assess community needs, and inform patients of charity policies. Some lawmakers, notably Sen. Chuck Grassley, an Iowa Republican, want tougher rules and oversight. The goal is to make sure they are providing enough service to the community to justify the tax break.

States, which make their own determination on who is exempt, may follow suit; in fact, Illinois just denied property tax exemptions to three hospitals.

As a report from the Hastings Center said, “A 2007 Internal Revenue Service report stated that about half of nonprofit hospitals spent 3 percent or less of revenues on charity care. Nowadays, hospitals are bringing in large amounts of money, paying their CEOs record amounts of compensation, and engaging in aggressive debt recovery actions.” Many of the hospitals use “sticker” prices to value their charity care, even though that’s not what the hospital gets from most patients.

In Georgia, the hospitals get millions in tax breaks. Nationally, the latest number I saw was $13 billion for federal taxes, and that doesn’t count state and local tax breaks. Pell explains:

Residents pay more in taxes because these hospitals are exempt. In exchange, taxpayer-subsidized hospitals are expected to provide charitable services – “a community benefit.”

But Georgia, like 35 other states, has no specific requirements hospitals must meet to justify these tax breaks.

And an Atlanta Journal-Constitution analysis of hospital data reveals that some not-for-profit hospitals provide less in community benefits – specifically, charity health care for the poor – than the tax-paying, for-profit hospitals they compete with.

It’s not all black and white; the article notes complexities such as a hospital that doesn’t provide much free care – but does heavily subsidize some local community clinics. And Georgia has instituted a “bed” tax on nonprofits and for profits alike to help generate some more money for Medicaid, which has been strapped during the nation’s economic crisis. Overall, it’s a good read and a roadmap for enterprise reporting in other communities. Pell wrote an article about how he did his reporting for AHCJ that spells out a number of tips for reporters.

That tip sheet has further resources, including advice on deciphering hospital financial records from this presentation from The Philadelphia Inquirer‘s Karl Stark. If you are interested in the topic and are still daunted by the data, see if you can find a reliable local advocacy group who can help you sort them out, or a health care finance professor in your state who may be able to help you out.

If you Google, you will find stories about highly paid executives at nonprofit hospitals – that’s a good part of the story, and one that readers/listeners/viewers can grasp, but it’s not the whole story. Nancy Kane, a professor at Harvard School of Public Health, (who explained a lot of this to me some years ago) wrote on this topic a lot for a while, but when I did a quick check, most of the work I found was several years old. Here are some current resources to help reporters check into the nonprofit hospitals in their areas:

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Credit crisis, IRS changes affect hospital finances (#ahcj09)

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

If ever there was a time to dig into your local hospital’s finances, this is it, Karl Stark told journalists Friday morning.

The Internal Revenue Service has made the first significant change to its 990 form in 30 years, providing more details about charity care and community benefits.

“And there are all these financial pressures coming down on hospitals this year,” said Stark, health and science editor of The Philadelphia Inquirer. That may result in a new wave of closures and mergers.

“One of the issues that has been undercovered, in my opinion, is the effect of the credit meltdown on hospitals,” he said.

During a presentation at Health Journalism 2009, Stark provided advice on how to demystify the financial numbers.

Sandy Kleffman of the Contra Costa Times writes about some key points from Stark’s presentation.