Nonprofit Hospitals: Addressing Social Determinants of Health in Community Health Needs Assessment through Community Benefit

Community Benefit for nonprofit hospitals began in 1959 when the IRS required hospitals to provide charity care in exchange for their tax-exempt status. In 2010, the Affordable Care Act attempted to bolster this longstanding policy with additional provisions of the Community Health Needs Assessment and Implementation Strategy to ensure nonprofit hospitals were addressing health needs in their community. However, given the growing evidence of the impact that social determinants have on health outcomes, nonprofit hospitals need to reevaluate their community benefit spending and invest more into upstream socioeconomic inequities. Nonprofit hospitals are essential partners in the community to address these social and structural inequities beyond clinical walls; and they can do so by leveraging their community health needs assessment and community benefits. This paper provides policy recommendations for nonprofit hospitals to increase its investment in social determinants of health