News Releases

Northeast Ohio Hospital Community Benefit Exceeds $2 Billion

Hospitals in Northeast Ohio provided $2.06 billion in community benefit in 2023 according to the latest analysis of their tax filings by The Center for Health Affairs. This is a 3.28% increase from the $1.99 billion in community benefit delivered by hospitals in 2022, and during a time when they are still struggling under economic pressures including high labor and supply costs.

The largest share of community benefit – the amount of financial assistance provided to the uninsured and the Medicaid population – rose to $1.283 billion, up 7.03% from $1.199 billion in 2022.

Total uncompensated care — inclusive of charity care and bad debt — equaled $851.5 million, a 7% increase over 2022.

Bad Debt & Medicare Shortfall

Medicare pays hospitals roughly 82 cents for every $1 of care provided. Medicare shortfall — the difference between the cost of providing services to Medicare beneficiaries and actual Medicare payment for those services — increased 3.26% to more than $227 million in 2023. While not included by the Internal Revenue Service (IRS) in its definition of community benefit, these are costs to hospitals associated with providing care to patients for which they are not reimbursed.

Bad debt — which is nonpayment for services by individuals that do not qualify for Medicaid or financial assistance — decreased by only 0.66% to $485 million in 2023.

The total dollar value of community benefit, bad debt and Medicare shortfall reached $2.8 billion in 2023.

Community Building

In addition to community benefit, the hospitals are also required to report community building activities as part of their tax filings. Overall, community building activities decreased 4.5% from $894,517 in 2022 to $854,000 in 2023.

The bulk of these activities – $590,000 – is attributed to community support. This can include, but is not limited to, childcare and mentoring programs for vulnerable populations, neighborhood support groups, violence prevention programs, and disaster readiness and public health emergency activities. Economic development, at $98,500, and coalition building, at $80,000, were the next largest contributors.

Salaries & Benefits

Among the largest employers in the region, Northeast Ohio hospitals also provide economic value in the form of salary, wages and benefits paid to hospital employees. In 2023, area hospitals contributed to the Northeast Ohio economy $10.95 billion in salaries and benefits — a 3.48% or $368 million increase over the previous year.

The cities where the hospitals are located, as well as the cities in which these wage earners reside, tax individuals on their earnings and bring valuable revenue to local communities.

About Community Benefit & The Center’s Analysis

Hospitals are cornerstones of their communities. They provide 24/7 emergency, acute and chronic care; they support initiatives to make their communities healthier; and they invest in research, medical innovation, and workforce development. To qualify for federal tax-exempt status, nonprofit hospitals must demonstrate that they provide broad community benefits that serve the public interest.

The Center’s community benefit analysis is based on data reported by non-governmental, acute-care hospitals on their IRS Form 990s. Government hospitals are not required to file an IRS 990. For this analysis, comparable independently reported data was used where provided. The following hospitals are included in this report: Cleveland Clinic Ohio hospitals, The MetroHealth System, Southwest General Health Center, and University Hospitals Health System.

For a national look at hospital community benefit, view the American Hospital Association’s report.