How do nonprofit and for-profit hospitals differ when it comes to community engagement and community health investment? One might assume that because for-profit hospitals are not required to provide charity care and other community benefits, that they don’t invest in community health. But that’s not the case, as researchers from the Ohio University Anchors Study found.

A study by professors Cory Cronin and Berkeley Franz found that for-profit hospitals were more likely than nonprofit and public hospitals to be in communities with greater economic and health needs.

Given their location in counties with high economic and health needs, for-profit hospitals have significant potential to impact population health if they are successfully incentivized to engage in population health improvement.


Preventive Medicine Reports, Vol. 22, 2021

Hospitals serve as anchor institutions in many U.S. communities and make contributions to bolster population health and reduce preventable death. Most studies to date have focused on nonprofit hospitals, but there may be significant opportunity for for-profits to fill this role in both urban and rural communities. Using 2017-2018 data, we calculated descriptive statistics and a multivariate regression model to assess economic and health characteristics for all U.S. counties that contain for-profit as compared to nonprofit or public hospitals (n = 4,622). After controlling for hospital and county characteristics, we found a significant and positive relationship between for-profit hospital presence and higher county unemployment, higher uninsured rates, and the number of residents reporting poor/fair health. For-profit hospitals were also less likely to be located in states that had expanded Medicaid or which had certificate-of-need laws. Our findings suggest that there is substantial opportunity for for-profit hospitals to serve as anchor institutions in many U.S. communities, despite this label more traditionally being applied to nonprofit hospitals. Given that there is not currently a regular reporting mechanism for documenting the community health contributions of for-profit hospitals, policymakers and researchers should evaluate the current state of these contributions and develop incentives to encourage more anchor activities to benefit economically vulnerable communities in the U.S.