A study in the April 2018 issue of the Journal of Health Politics, Policy, and Law investigated the relationship between state regulatory requirements and hospital community benefit expenditures using The Hilltop Institute’s online resource, the Community Benefit State Law Profiles and Internal Revenue Service data. Using multivariate regression analyses, the researchers examined four types of regulation (requirements to report community benefits, conduct community health needs assessments, provide minimum levels of community benefits, and adhere to minimum income eligibility standards for charity care) and the level and types of hospital-provided community benefits. Community health needs assessments were consistently associated with greater community benefit spending. Further, adoption of multiple types of state regulation was associated with higher levels of hospital-reported community benefits. Read the Article

Hilltop’s Community Benefit State Law Profiles present a comprehensive analysis of each state’s community benefit landscape as defined by its laws, regulations, tax exemptions, and, in some cases, policies and activities of state executive agencies and organize these state-level legal frameworks by the major categories of federal community benefit requirements found in Section 9007 of the Affordable Care Act (ACA), Section 501(r) of the Internal Revenue Code. In addition, they provide a needed contextual basis for consideration of these policies against those of other states and federal community benefit benchmarks. The State Comparison Table displays the data visually and allows the user to sort by a selected community benefit requirement, access state-specific details about a selected legal requirement, and compare the community benefit requirements of multiple states.


Hilltop’s Hospital Community Benefit Program is a central resource created specifically for state and local policymakers who seek to ensure that tax-exempt hospital community benefit activities are responsive to pressing community health needs. The program provides tools to state and local health departments, hospital regulators, legislators, revenue collection and budgeting agencies, and hospitals, as these stakeholders develop approaches that suit the unique needs of their communities and work toward a more accessible, coordinated, and effective community health system.

The Hilltop Institute at the University of Maryland, Baltimore County (UMBC) is a non-partisan health research organization dedicated to improving the health and wellbeing of people and their communities. Hilltop conducts research, analysis, and evaluations on behalf of government agencies, foundations, and nonprofit organizations at the national, state, and local levels. Hilltop is committed to addressing complex issues through informed, objective, and innovative research and analysis.


The Hilltop Institute
University of Maryland, Baltimore County
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1000 Hilltop Circle
Baltimore, Maryland 21250