(Raleigh, N.C.) — An analysis released by Johns Hopkins Bloomberg School of Public Health and the North Carolina State Health Plan revealed that the majority of North Carolina nonprofit hospitals are not fully honoring their charitable mission. Although nonprofit hospitals reap lucrative tax breaks in exchange for serving the poor, their charity care spending varies wildly and with little accountability. Researchers from Johns Hopkins Bloomberg School of Public Health found troubling disparities in North Carolina hospitals’ charity care spending.
Fewer than 25 hospitals exceeded the value of their tax exemption with the amount of their charity care spending in North Carolina. Our analysis suggests that North Carolina’s largest nonprofit hospital systems reaped tax breaks worth more than an estimated $1.8 billion in 2019-2020. Across the majority of these systems, charity care spending did not exceed 60% of the value of their tax breaks. On average, North Carolina hospitals were far more profitable than the national average. But one in five families in North Carolina has medical debt in collections.
“Charity care is the heart of what it means to be a nonprofit hospital,” NC State Treasurer Dale Folwell said. “Our hospital systems justify overcharging state employees and taxpayers by pointing to their charity care costs. But now we know that is not fully accurate. They are profiting on the backs of sick patients.”
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