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Wisconsin's nonprofit hospitals, which account for nearly all hospitals in the state, provided 40 percent less charity care and made 40 percent more money than the national average from 2003-07. St. Mary's Hospital, one of three nonprofit hospitals in Madison, paid for a $140 million addition with cash reserves – unheard of before in the state – after providing less charity care and making a lot more money than the state and national averages for several years. The tax breaks the Madison hospitals receive likely exceed their charity care and uncompensated care, but it's difficult to estimate the total amount of all tax breaks. Municipal officials and lawmakers are increasingly forcing hospitals to make payments in lieu of taxes and better account for and justify their tax breaks.

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