Hospital-based Community Benefit Programs: A Review of Recently Published Literature

Principal Investigator(s)

Steven M. Albert, PhD


  • Jessica G. Burke, PhD, MHS

Not-for-profit hospitals, as part of their tax exempt status, are required to submit information about their community health benefit activities on the Internal Revenue Service Form 990 Schedule H. Several studies now suggest that the lack of guidelines and difficulty quantifying community benefit can lead to variation in community benefit claims. Furthermore, the Patient Protection and Affordable Care Act, section 501(r) of the United Sates Internal Revenue Code requires each tax-exempt hospital to conduct community health needs assessments. These assessments should indicate areas of community health need and direct hospital community benefit programs. Drs. Steve Albert and Jessica Burke, from the Department of Behavioral and Community Health Sciences at the University of Pittsburgh Graduate School of Public Health are working to help hospitals address these requirements by analyzing the peer-reviewed evidence base for community benefit programs.  In collaboration with University of Pittsburgh Health Sciences Library System and Health Policy Institute, they conducted a systematic literature review to 1) Identify and critically appraise the peer-reviewed literature regarding hospital- based community benefits programs; and 2) Identify key exemplar hospital-based interventions with positive health outcomes. This literature review yielded several conclusions. Out of 4,917 abstracts matching the key terms of our database search, only 107 articles presented programs that included all of the category requirements: 1) hospital associated, 2) benefit to the community at large, 3) evaluated and measured, 4) published in peer-reviewed literature within the last 5 years and 5) conducted in the U.S. The literature results revealed a wide range of programs with a focus on community health. None of the programs self-identified as programs resulting from a Community Health Needs Assessment. This diversity suggests that there is a need to establish standardized criteria for hospital-based community benefit programs. Considering the broad scope of hospital-based programs already in place but not yet published, Drs. Albert and Burke strongly recommend that hospitals focus on program evaluation. The methodology of program evaluation is an essential tool in identifying programs that are producing optimal and positive outcomes. The Patient Protection Affordable Care Act will require greater investment in evaluation, so that hospitals can provide scientific evidence of public health improvements within their community.



Burke, J. G., Truong, S., Albert, S., Steenrod, J., Gibert, C., Folb, B., et al. (2014). What can be learned from the types of community benefit programs that hospitals already have in place? J Health Care Poor Underserved, 25(1 Suppl), 165-193.