NH Journal – November 21, 2024
By MICHAEL GRAHAM
The approaching holiday season and the proposed acquisition of Catholic Medical Center by HCA have raised the focus on the role charity hospitals play for Granite Staters in need. And while CMC and HCA have made a commitment to providing charitable care if their deal goes through, an analysis shows not all New Hampshire nonprofit hospitals are serving their communities at the same level.
For many needy families in New Hampshire, one pillar of the safety net is their local nonprofit hospital. In 2020, America’s 3,000 or so nonprofit hospitals provided $16 billion in charity care to millions of patients. New Hampshire’s hospitals provided more than $594 million in community benefits in 2020, according to a report by the Foundation for Healthy Communities. “Hospitals and health systems are cornerstones of their community and proudly partner with many other stakeholders to improve the health of the patients and communities they serve,” said Steve Ahnen, President of the New Hampshire Hospital Association.
When hundreds of members of the Manchester community came together last month to discuss the proposed CMC/HCA deal, many of the questions were about whether charitable care would continue. The purchase agreement includes the creation of a nonprofit foundation to carry on CMC’s community service and provide charity care to the uninsured. In fiscal year 2023, that amounted to $91 million worth of uncompensated care to the community, according to Laura Montenegro, CMC’s director of communications.
“Catholic Medical Center is committed to providing compassionate, high-quality care to all individuals, regardless of their financial situation. Rooted in the values of our faith, we believe that every person deserves access to healthcare, and we strive to serve the sick and vulnerable in our community with dignity, compassion, and respect.” But not all nonprofits make the same investment in charitable care. The Lown Institute conducts a “fair share” review of more than 2,400 nonprofit hospitals, comparing their spending on financial assistance and community health investments to the estimated value of the tax exemptions they receive as nonprofits.
Both Concord Hospital and Elliott Hospital received an “A” rating for the amount of assistance they provide to the community, when compared to the value of the tax benefits they receive as nonprofits. On the other end of the spectrum is St. Joseph Hospital in Nashua, with a “D” rating. It’s ranked at the bottom of the 13 nonprofit hospitals in the state for community benefit. In fact, it ranks 2,661 out of the 2,752 hospitals reviewed nationwide. And another source shows St. Joseph commits only 0.49 percent of its total expenses to providing charitable care. St. Joseph did not respond to a request for comment.
Now some healthcare analysts are raising questions about whether the charitable services offered by nonprofit hospitals are worth the costs to taxpayers in lost revenues. At least one study has found that for-profit hospitals as a whole give nearly the same percent of total expenses to charity care as nonprofits. When Americans are surveyed each year and asked what they are most thankful for, “good health” and “the health of my family and friends” consistently rank as top responses. With inflation creating economic hardships for working-class Granite Staters and the cost of healthcare rising (another 4.1 percent increase in 2022 alone), the need for charitable care has never been greater. New Hampshire is fortunate to have one of the healthiest populations in the nation and one of the wealthiest. For those who want to show their gratitude by giving to others, nonprofit hospitals offer multiple ways to help, from volunteering on site to transporting patients to — of course — financial contributions. To review the performance of the nonprofit hospital in your community, visit the Lown Institute Hospital Index here. https://lownhospitalsindex.org/