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Posted: 2018-12-05 15:40:43

December 3, 2018; Chicago Business

Rush University Medical Center, author of the Anchor Mission Playbook published last year, is widely seen as a nonprofit hospital leader in addressing community needs. As Alex Kacik writes in Chicago Business, in 2017, Rush, working with a community coalition known as West Side United led dozens of “learning map” meetings throughout Chicago’s West Side “to learn what residents needed and how to meet those needs.” But as Kacik points out, not all hospitals are like Rush. “Without explicit rules guiding hospitals’ interventions or setting a baseline level of funding, community benefit programs and their spending vary wildly,” Kacik explains.

Community benefit is a term used by the Internal Revenue Service (IRS) to denote community-based activities performed by nonprofit hospitals. The IRS requires nonprofit hospitals to fill out their Schedule H on their Form 990 filings to detail the work they do on the community’s behalf. Unfortunately, expecting a tax collection agency to be an effective overseer of the public health benefits of nonprofit hospitals is a tall order. And most often, the existing regime falls short.

The stakes are high. On Chicago’s West Side, which corresponds to Rush’s service area, West Garfield Park residents can expect to live 69 years, while six miles away, residents in the high rises of the Loop have a life expectancy of 85 years. “Problems identified in the West Side,” Kacik notes, “ranged from a lack of major grocery stores to unchecked mental health issues and systemic racism that keeps the school-to-prison pipeline flowing.”

But, by and large, as Kacik details, community benefit strategies still largely fail to address such social determinants of health. This is true even though up to 90 percent of all health outcomes have to do with factors other than the presence or quality of clinical care.

Gary Young, director of the Center for Health Policy and Healthcare Research at Northeastern University, tells

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