Alignment of Community Benefit Spending and Initiatives to Improve Community Health: Is There Evidence of Progress?

ObjectivesWe sought to identify changes in non-profit hospitals’ community benefit spending from 2014 to 2019. Secondly, we wanted to find novel predictors of spending in the most recent available data.MethodsFor our longitudinal analysis, we used tax filing data for 1072 hospitals from 2014-2019 and time-based ANOVA. We gathered information about hospital characteristics, the social determinants of health, and hospital partnerships with local communities for 1192 hospitals for the year 2019. We employed multivariate regression to identify significant factors.ResultsTotal community benefit spending rose from 8.1% in 2014 to 9.1% of operating expenses in 2019, driven by increased spending on patient care. There was no such increase in spending on activities targeted at improving community health. The presence and strength of partnerships between hospitals and their communities were associated with higher community benefit spending.ConclusionsWe found no evidence of dramatic shifts in community benefit spending from 2014 to 2019. Further, we identified partnerships for population health improvement as an effective, novel predictor of community benefit spending. Supporting partnerships between hospitals and communities may help facilitate strategic investments in community health improvement.