2023 Results


How much are hospitals giving back to their communities?

VIDEO: Our April 11, 2023 launch event featured Lisa Frank, Chief Operating Officer and Administrative Officer for the City of Pittsburgh; Steven Ranzoni, Hospital Policy Advisor at the Oregon Health Authority; Naman Shah, Director of Medical and Dental Affairs at the Los Angeles County Department of Public Health; Nancy Dolson at the Colorado Department of Health Care Policy and Financing; and Vikas Saini, President of the Lown Institute.

The Lown Institute Hospitals Index is the first ranking to measure meaningful community investment for nonprofit hospitals nationwide. (press release | methodology

The Institute calculated “fair share” spending for more than 1700 nonprofit hospitals, by comparing each system’s spending on financial assistance and community investment to the estimated value of its tax exemption. The data source for “fair share” spending is IRS Form 990 for fiscal year ending 2020.

Key Takeaways

  • Out of 1,773 nonprofit hospitals evaluated, 77% spent less on charity care and community investment than the estimated value of their tax breaks — what we call a “fair share” deficit.
  • The total “fair share” deficit for these hospitals amounted to $14.2 billion in 2020. That’s enough to erase the medical debts of 18 million Americans or rescue the finances of more than 600 rural hospitals at risk of closure.
  • Many of the hospitals with the largest “fair share” deficits also received millions in COVID-19 relief funding and ended the year with high net incomes.
  • In four states (MA, MN, RI, and Washington, DC), the total “fair share” deficit for all hospitals is enough to wipe out all medical debt on credit reports in the state.
  • In 41 states, the total “fair share” deficit for all hospitals is enough to cover the net losses of all rural hospitals in the state in 2020.

Media inquiries should be directed to Aaron Toleos, vice president of communications for the Lown Institute, at atoleos@lowninstitute.org.