Related Experiment Videos
Measuring Nonprofit Hospitals' Provision of Charity Care Using IRS and CMS Data
Darrell J Gaskin1, Bradley Herring, Hossein Zare
1Richardson Professor in health policy and director, Johns Hopkins Center for Health Disparities Solutions, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland associate professor of health economics in health policy and management, Johns Hopkins Bloomberg School of Public Health assistant scientist, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health and Johns Hopkins Center for Health Disparities Solutions and adjunct assistant professor, University of Maryland University College, Adelphi, Maryland; and professor of health policy and management and international health, Johns Hopkins Bloomberg School of Public Health, and director, Center for Hospital Finance and Management.
Executive Summary:
We explore whether nonprofit hospitals report similar amounts of charity care to the Internal Revenue Service (IRS) and Centers for Medicare & Medicaid Services (CMS). We use nonprofit hospitals' financial reports to the IRS and the CMS Medicare costs report for 2011 and 2012. In 2012, hospitals reported spending 7.6% more in charity care to the IRS than to CMS: 2.54% of revenues ($5.74 million per hospital) to the IRS versus 2.36% ($5.16 million) to CMS. While the averages are close, there are wide discrepancies for individual hospitals. For example, despite efforts for standardization, 80% of hospitals reported charity care to the CMS that was 40% greater in absolute value than what they reported to the IRS, and only 10% of hospitals reported charity care to CMS that was within 20% of what they reported to the IRS. Our findings suggest that individual hospitals routinely report different amounts of charity care to the IRS and CMS, yet we find relatively few hospital or market characteristics that may explain these differences.