Winning Hospitals 2021


Hospitals say they want to be community partners…these hospitals are actually doing it.

The Lown Institute Hospitals Index is the first ranking to examine hospital spending on charity care and community investment for over 3,600 U.S. hospitals.  (press release | methodology

Hospitals were ranked based on charity care spending, spending on other community health initiatives, and the proportion of patient revenue from Medicaid (a measure of the hospital’s commitment to taking care of low-income patients). Data sources were hospital tax filings and cost reports from the Centers for Medicare and Medicaid from 2018.

The Institute also calculated “fair share spending” for 2,391 private nonprofit hospitals by comparing each hospital’s spending to the value of its their tax exemption. The fair share calculation is a separate analysis from the overall community benefit ranking, and is only conducted for private nonprofit hospitals.

Watch our launch video featuring Sara Rosenbaum, Professor of Health Law and Policy at George Washington University, and Marty Makary, Professor of Health Policy & Management at the Johns Hopkins Bloomberg School of Public Health.

Key Takeaways

  • 72% of private nonprofit hospitals had a fair share deficit, meaning they spent less on charity care and community investment than they received in tax breaks.
  • The combined fair share deficit for private nonprofit hospitals was $17 billion, with individual hospital deficits ranging from a few thousand dollars to $261 million.
  • The ten hospitals with the largest fair share deficits accounted for more than ten percent ($1.8 billion) of the nation’s total.
  • Public hospitals, which are tasked with caring for all regardless of ability to pay, are well-represented on the list of top hospitals for community benefit.

Media inquiries should be directed to Aaron Toleos, vice president of communications for the Lown Institute, at