Summary: Pursuant to a congressional request, GAO assessed the role of nonprofit hospitals in providing: (1) acute medical care to indigents; and (2) other community services, such as health education and screening.
GAO found that: (1) nonprofit hospitals provided a lower percentage of their states' uncompensated care than the percentage of hospital care they provided in the state; (2) uncompensated care expenses were not distributed proportionately throughout the nonprofit sector, but were concentrated in large teaching hospitals in cities; (3) the nonprofit hospitals with the lowest uncompensated care rates had better financial results than other nonprofit hospitals, while those with the highest uncompensated care rates had the poorest financial results; (4) hospitals whose potential tax liability exceeded their uncompensated care expenses had proportionately higher net incomes than other hospitals in their states; (5) between 43 and 71 percent of the nonprofit hospitals in the five states GAO examined provided less charity care than estimates indicated; (6) some hospitals' goals did not focus on the health needs of the poor or underserved in their community; (7) physician staffing and charity admissions policies discouraged indigent admissions except in emergency cases; and (8) nonprofit hospitals were more likely than investor-owned hospitals to offer community services, but were equally likely to charge patients for them and more likely to recover their costs.
