North Carolina nonprofit hospitals' charity care rarely exceeds tax breaks, report shows

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A majority of North Carolina nonprofit hospitals' charity care spending did not exceed 60 percent of their tax breaks in 2019 and 2020, an Oct. 27 analysis by Johns Hopkins Bloomberg School of Public Health and the North Carolina State Health Plan showed.

North Carolina State Treasurer Dale Folwell invited researchers from both organizations to create the report, according to a press release from his office.

The report found that fewer than 25 hospitals surpassed the amount of their tax exemption through their charity care spending, while the largest hospitals in the state collected tax breaks of more than $1.8 billion in 2019 and 2020.

Several major health systems are named in the report, including Charlotte-based Atrium Health, Charlotte-based Novant Health and Chapel Hill-based UNC Health. A spokesperson from Atrium Health told Becker's that Medicare and Medicaid don't reimburse the full amount for what it costs to deliver care and that Atrium is the state's largest provider of Medicaid services.

"Throughout the pandemic — and even well before — Atrium Health has continually invested in underserved areas of the communities we are privileged to serve," the spokesperson told Becker's. "Not only do we provide the most health care to residents throughout the state, we are also proud to be the largest provider of community benefit, giving back more than $2 billion in community benefit each year, which includes free and uncompensated care. We have a long tradition of improving health within our communities — areas like hunger and homelessness — in addition to increasing access to care outside the walls of our hospitals. We do not turn anyone away based on their ability or inability to pay and we remain centered on our 'for all' mission."

Greenville, N.C.-based Vidant Health, which was also named in the report, provided the following statement to local NBC affiliate WITN:

"Vidant Health serves a vast, underserved region of more than 1.4 million people, many of whom face high rates of chronic diseases, lack access to care and are uninsured. As a mission-driven not-for-profit health system, Vidant treats all patients regardless of ability to pay and prides itself on providing charity care to community members in-need. With a reliance on a high government payor mix (Medicare, Medicaid), Vidant operates with a thin margin and any profits realized are reallocated to create access to quality care, hire high-quality doctors and nurses, and create health infrastructure needed to support the communities we are proud to serve."

Novant Health deferred its comment to the North Carolina Healthcare Association, which did not respond to Becker's request for comment before publication.

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