Additional scrutiny of non-profit hospitals

For quite some time, non-profit hospitals have agreed to provide benefits to the community (e.g. free or reduced medical care for some patients) in exchange for not having to pay income tax. Over the last several years, however, members of the public have been arguing that the exchange no longer makes sense, primarily because the non-profit hospitals are not providing enough community benefit, and in some cases, are suing patients who are unable to pay. As healthcare prices have continued to escalate and some non-profit hospitals seem to provide less community benefit than taxes they would have been obligated to pay without the non-profit status, the industry has been receiving additional scrutiny. KFF Health News published an article about the state of Montana proposing new rules to oversee non-profit hospitals.

Part of the context is that hospitals might have a financial assistance policy, but might make it difficult for eligible patients to find out what the details are. The current proposal appears to be mostly aimed at data collection (e.g. not yet mandating certain patient education policies). A researcher is quoted in the article as saying that the proposed rules are not meaningful. The article elsewhere explains that the Montana Hospital Association lobbied against "too many reporting rules" and that legislators responded by limiting the data requirements "to largely the information hospitals already provide to the federal government." Regardless, that there is more scrutiny in this area, following a 2020 report and a 2023 law, gives an indication of the extent to which people are looking for ways to push back on the overall cost of healthcare. The article also reports on some similar efforts in Oregon and California, demonstrating that the interest goes beyond a single state. Efforts will need to go far beyond merely collecting data, but having data is an important early step.