IHA Community Benefit Report
The IHA Community Benefits Report is an integral part of IHA advocacy efforts and hospital community benefit reporting obligations, as charity care and other hospital community benefits and their relationship to nonprofit hospitals’ tax-exempt status remain in the focus of legislators, the media and the public.
Charity Care Charity Care - $198,234,925
Charity care is free or discounted health services provided to persons who cannot afford to pay and who meet the organization's financial assistance policy criteria.
Subsidized Health Services - $47,978,842
Clinical programs that are provided despite a financial loss so significant that negative margins remain after removing the effects of charity care, bad debt and Medicaid shortfalls.
Community Benefits Programs & Services - $174,891,564
Comprised of the following:
Community Health Improvement service Community Health Improvement service - $41,308,803
These activities are carried out to improve community health, extend beyond patient care activities and are usually subsidized by the health care organization.
Research - $50,990,908
Research includes clinical and community health research, as well as studies on health care delivery that are generalizable, shared with the public and funded by the government or tax-exempt entity (including the organization itself).
Financial and In-Kind Contributions - $17,137,980
This category includes funds and in-kind services donated to individuals not affiliated with the organization or to community groups and other not-for-profit organizations.
Community Health Improvement service Health Professions Education - $55,194,175
Community health education includes lectures, presentations, and other group programs and activities apart from clinical or diagnostic services. Community benefit in this area can include staff time, travel, materials, staff preparation and indirect costs.
Health Professions Education Community-building Activities - $8,139,052
Community-building activities include programs that address the root causes of health problems, such as poverty, homelessness, and environmental problems.
Community Benefits Operations - $1,860,646
Community benefit operations include costs associated with assigned staff and community health needs and/or assets assessment, as well as other costs associated with community benefit strategy and operations.


Total 2016 Community
Benefits Contribution*

4.3 million persons served through
community service programs

Expenses currently included in the community benefit contribution total are:

  • Bad Debt Expense (at cost): $270,261,292
    Services for which the hospital expects but does not collect payment.
  • Medicare Losses (at cost): $161,885,463 (FY 2015)
    Care for the elderly not reimbursed by Medicare.
  • Medicaid Losses (at cost): $49,986,243 (FY 2016)
    Created when a facility receives payments less than the cost of caring for "means tested" public program beneficiaries.

Bad Debt, Medicare and Medicaid Losses, contribute to $482,132,998 of the community benefit total.

"By communicating the benefits organizations provide - responding to community health needs, improving health in the community, and serving those in need-organizations illustrate accountability to their communities."
Source: CHA Guidelines

 *The discontinuation of the Iowa Cares program has led to a substantial decrease in accounting for Charity Care.