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Mixed-Methods Analysis of Community-Building Activities in Minnesota Hospitals

journal contribution
posted on 2025-01-21, 05:16 authored by Hannah Macdougall, Robert Libal, Lacey Loomer
Abstract Nonprofit hospitals are required to annually report spending on community-building activities (CBAs) to the Internal Revenue Service. CBAs are actions that address root causes of community health problems such as housing and food insecurity. While addressing these issues is important regardless of location, CBA spending could particularly benefit rural residents who, on average, experience worse health outcomes. However, national CBA spending has historically been extremely low, potentially due to confusion surrounding reporting. This explanatory mixed-methods study sought to illuminate nonprofit hospital spending patterns on CBAs in one state, Minnesota, to understand why spending in this important category is so low. Authors first conducted quantitative analyses of publicly available tax return data for the year 2019’ which revealed no statistically significant differences in CBA spending by rural location or hospital system affiliation. Authors then performed a case study of the top spending hospitals’ narrative statements provided in nonprofit hospital tax return documents and found significant variation in what is reported as a CBA. We suggest CBA spending be reported differently to reduce confusion and render tax documents more accurate portrayals of nonprofit hospital spending, thereby providing policymakers with needed information to ensure nonprofit hospitals are financially supporting community health.

History

Journal

Health & Social Work

Volume

49

Pagination

255-263

Location

Oxford, Eng.

Open access

  • No

ISSN

0360-7283

eISSN

1545-6854

Language

eng

Publication classification

C1.1 Refereed article in a scholarly journal

Issue

4

Publisher

Oxford University Press

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