For centuries, the Catholic Church has been a major social actor in the provision of health services, particularly health care delivered in hospitals. Through a confluence of powerful environmental forces at the beginning of the twenty-first century, the future of Catholic health care is threatened. Although Catholic hospitals are a separate case of private, nonprofit hospitals, they have experienced environmental pressures to become isomorphic with other hospital ownership types and, on some dimensions, they are equal.
"Community benefit" is the measurable contribtution made by Catholic and other tax-exempt organizations to support the health needs of disadvantaged persons and to improve the overall health and well-being of local communities. Community benefit activities include outreach to low-income and other vulnerable persons; charity care for people unable to afford services; health education and illness prevention; special health care initiatives for at-risk school children; free or low-cost clinics; and efforts to improve and revitalize communities.
In a time of public scrutiny, it is paramount that Catholic health care organizations examine their commitments to their communities and effectively communicate community benefit activities to stakeholders-employees, physicians, patients, and the public. CHRISTUS Academy, a leadership development program at CHRISTUS Health, Irving, TX, conducted two studies regarding community benefit.
"While contemporary Catholic health care and other not-for-profit health care institutions excel in quality, innovation and technology, they remain community-benefit organizations, founded and sustained because of community need," Sister Carol Keehan, a Daughter of Charity who chairs the board of trustees of the Catholic Health Association of the United States, said in May 26 testimony in Washington before the House Ways and Means Committee, which conducted a hearing on the tax-exempt hospital sector. Keehan chairs the board of Sacred Heart Health System in Pensacola, Fla.
A Senate hearing last week helped boost not-for-profit hospitals' chances of facing a new standard for reporting community benefits. At stake for hospitals are billions in tax breaks. The standard for exemption hasn't been modified since 1969, and "has not kept up with the substantial unfunded health needs of communities," says Nancy Kane, right, a member of MedPAC.
BACKGROUND: Catholic hospitals and health systems comprise a substantial segment of nonprofit, mission-driven, health care services, with accountability to institutional pressures of the Roman Catholic Church as well as economic pressures for solvency. Values are the way in which the organization expresses its faith-based institutional identity, which may used to select services that represent those values.
The 2010 Patient Protection and Affordable Care Act (ACA) requires not-for-profit hospitals, including Catholic hospitals, to engage in meaningful community assessment and collaboration efforts in order to maintain their tax-exempt status. Now that the ACA has been upheld by the U.S. Supreme Court, this paper argues that the requirements related to a more robust community engagement process should be embraced by Catholic not-for-profit hospitals and health systems.
International Journal of Health Care Finance and Economics
This paper addresses two seeming paradoxes in the realm of employer-provided health insurance: First, businesses consistently claim that they bear the burden of the insurance they provide for employees, despite theory and empirical evidence indicating that workers bear the full incidence. Second, benefit generosity and the percentage of premiums paid by employers have decreased in recent decades, despite the preferential tax treatment of employer-paid benefits relative to wages-trends unexplained by the standard incidence model.
Canadian HIV/AIDS policy & law review / Canadian HIV/AIDS Legal Network
On 30 April 2001, the Tax Court of Canada granted judgment in favour of a Victoria woman who claimed that she should be entitled to deduct from her taxable income, as legitimate "medical expenses," her expenses for vitamin supplements and for rehabilitative therapies such as massage and therapeutic touch.