Kelsey M. Owsley, MPH


Curriculum vitae


Department of Health Systems, Management, and Policy


University of Colorado - Anschutz Medical Campus



JMP: Understanding the Relationship between Nonprofit Hospital Community Benefit Spending and System Membership: An Analysis of Independent Hospital Acquisitions


Journal article


Kelsey M. Owsley, Richard C. Lindrooth


The Internal Revenue Service (IRS) requires nonprofit hospitals to report community benefit spending to justify nonprofit tax exemption. However, there are no national benchmarks defining acceptable spending levels. Ideally, the level of spending should be commensurate to profits but there is conflicting evidence as to whether that is the case. In this paper, we examine whether nonprofit hospital acquisitions influence the amount and type of community benefit spending. We analyzed 2011-2016 data on urban, nonprofit hospitals that were independently licensed in 2011 from the American Hospital Association Survey, CMS Hospital Cost Reports, and IRS Form 990 Schedule H. The analysis dataset included 58 hospitals that were acquired between 2012-2015 and a matched control group. We used linear regression models with hospital-level fixed effects and market-level covariates within difference-in-differences specifications designed to measure the effect of acquisitions on total community benefit spending, and three subcategories – clinical, population health, and other spending types. Sub-analyses assessed if estimates were dependent on whether the acquirer was new to the local market. We found that acquisitions led to decreased population health spending (−$0.38 million, p<0.01) and other spending categories (−$1.3 million, p<0.05) at acquired hospitals compared to the matched control group. If the acquirer was located out-of-state, total community benefit spending declined by $2.1 million (p<0.10), whereas acquirers located in-state had a slight increase in total spending. Our findings support the need for community benefit spending to be considered, along with quality, efficiency, and prices of traditional hospital services, when evaluating the welfare impact of acquisitions. 


 


Cite

APA
Owsley, K. M., & Lindrooth, R. C. JMP: Understanding the Relationship between Nonprofit Hospital Community Benefit Spending and System Membership: An Analysis of Independent Hospital Acquisitions.

Chicago/Turabian
Owsley, Kelsey M., and Richard C. Lindrooth. “JMP: Understanding the Relationship between Nonprofit Hospital Community Benefit Spending and System Membership: An Analysis of Independent Hospital Acquisitions” (n.d.).

MLA
Owsley, Kelsey M., and Richard C. Lindrooth. JMP: Understanding the Relationship between Nonprofit Hospital Community Benefit Spending and System Membership: An Analysis of Independent Hospital Acquisitions.