Strengthening Healthy Communities Minnesota’S Hospitals: Strengthening Healthy Communities Minnesota Hospitals’ Community Contributions Total $4.2 Billion

2014 Community Benefit Report Minnesota’s hospitals: Strengthening healthy communities Minnesota’s hospitals: Strengthening healthy communities Minnesota hospitals’ community contributions total $4.2 billion Minnesota’s hospitals and health systems are under-insured or government-insured residents; years ahead. Through these Community Health driven by a mission to provide high quality health community health services and initiatives; Needs Assessments, hospitals are able to develop care that extends beyond the hospital’s walls. health education and wellness programs; and tailored approaches that are as unique and diverse As nonprofits, Minnesota hospitals are dedicated more. In 2013, Minnesota hospitals provided as the communities themselves. to promoting and improving the health of local more than $4.2 billion in contributions to their communities and their residents by providing communities, while providing care for 549,605 We know that much of what influences our health a range of vital services to meet the unique inpatient admissions, more than 11.3 million happens outside of the doctor’s office — in needs of the communities they serve. These outpatient registrations and more than 1.8 million our schools, workplaces and neighborhoods. include free or discounted care for the uninsured, emergency room visits. According to the U.S. Centers for Disease Control and Prevention, more than half of all Americans As part of the Patient Protection and Affordable live with a preventable chronic disease, many of What are community benefits? Care Act (ACA), each charitable hospital partners which are related to obesity, poor nutrition and Community benefits are health care- with their community to assess the health needs lack of physical exercise. Minnesota’s hospitals related services that Minnesota’s nonprofit of its local residents, prioritizes those needs and share a common goal of improving the health of hospitals provide—often with little or no develops a plan to address those needs in the Minnesotans and lowering the cost of care. By compensation—to address critical needs working to get Minnesotans healthy and keep in the community. These services include: them healthy, we’ll keep you out of the hospital. y Health services to vulnerable or Put into perspective, the underserved people $220 million in charity care Hospitals understand they play a critical role y Financial or in-kind support of public provided by hospitals is in strengthening the health of Minnesota’s health programs equivalent to the following: communities and are working to promote healthier y Health education screening and 463,590 FREE lifestyles through programs designed to get people prevention services emergency department to increase their physical activity, eat the right foods y Medical research projects visits OR and manage their health. This report shares just y Physician training initiatives a few examples of the many ways Minnesota’s 2,175,660 FREE hospital hospitals are strengthening healthy communities. Minnesota’s hospitals provide these physician clinic visits benefits through financial assistance, OR This report covers community benefit contributions charity care and subsidies for services made by Minnesota’s hospitals in 2013 — the most otherwise not available in the community, 1,627,716 FREE digitial recent year for which data are available. among other things. mammograms Minnesota Hospital Association 1 2014 Community Benefit Report Uncompensated care — $573 million fall under this category, which totaled $459 million Research — $237 million in 2013. Every day, hospitals offer their care at no cost. In 2013, Minnesota hospitals spent $237 million In 2013, Minnesota hospitals provided $573 million on research to support the development of better to patients who didn’t have health insurance or the Education and workforce development medical treatments and to find cures for disease. means to pay for their care. In the past 5 years, — $431 million uncompensated care has increased 20 percent. Minnesota’s health care workforce will take care Government underfunding — $2 billion of new people who gain insurance as a result of When hospitals treat patients on Medicare the Affordable Care Act and an aging population. Services responding to specific or Medicaid, those government health care In 2013, Minnesota hospitals spent $431 million to community needs — $459 million programs do not reimburse hospitals the full help train doctors, nurses and other highly skilled Health screenings, health education and health amount it costs the hospitals to provide the health care professionals to care for our residents. fairs, immunization clinics, subsidized health care. In 2013, such government underfunding to services and other community outreach programs Minnesota hospitals exceeded $2 billion, or 9.3 percent of the hospitals’ operating expenses. We hope the stories in this report will inspire you Hospital community contributions Trends in uncompensated care to support local hospitals so they can provide 2009-2013 2009-2013 600 the critical community health care services to 575 improve health, access to care, and quality of 550 $573 m life in our communities. 4.4 525 4.2 500 $521 m $509 m 4.0 $4.2 b 475 $496 m $477 m 450 3.8 $3.9 b 3.6 425 3.4 $3.6 b 400 3.2 $3.4 b 375 3.0 $3.2 b 350 2.8 325 2.6 300 in millions 275 in millions 2.4 2.0 250 1.8 225 1.6 200 Table of contents 1.4 175 Minnesota hospitals’ 2013 1.2 150 1.0 125 community contributions .................... 3 0.8 100 Hospital stories ....................................... 4 0.6 75 2013 community contributions 0.4 50 0.2 25 by region .......................................... 10 0 0 Glossary ............................................... 13 2009 2010 2011 2012 2013 2009 2010 2011 2012 2013 Minnesota Hospital Association 2 2014 Community Benefit Report Minnesota hospitals’ 2013 community contributions Charity care ...........................................................................................$219,741,687 Costs in excess of Medicaid payments ..............................................$713,315,179 Medicaid surcharge ..............................................................................$141,708,476 MinnesotaCare tax................................................................................$250,321,921 Other costs in excess of public program payments ...........................$27,373,083 Community services and benefit operations .......................................$55,107,901 Subsidized health services..................................................................$403,662,907 Education and workforce development .............................................$430,626,425 Research ...............................................................................................$236,631,606 Cash and in-kind donations ..................................................................$21,818,714 Total cost of community benefits (as defined by the IRS) ........................................................... $2,500,307,899 Percent of total operating expenses...............................................................11.3% Community building .................................................................................$7,135,679 Costs in excess of Medicare payments...........................................$1,301,596,976 Other care provided without compensation (bad debt) ....................$353,237,368 Total value of community contributions .............................. $4,162,277,923 Minnesota Hospital Association 3 2014 Community Benefit Report Allina Health creates community connections to improve health Despite having access to world-class medical care projects. More than 6,600 community members CHAT helped residents grow their own food by right in their “backyard,” many residents of South participated in CHAT activities during 2013, with supporting 10 local families as they built “Family Minneapolis experience poor health outcomes. 175 residents actively leading CHATs – this Gardens”; established partnerships with Youth Allina Health’s Backyard Initiative goes beyond means that approximately 15 percent of residents Farm, Happy Acre Farm and the Southside Local medical care to improve health by empowering participated in the Backyard Initiative. As one Foods Resource Hub to train youth and families residents to strengthen their own health. resident said: “For me, the greatest benefit has on gardening techniques; and distributed 6,000 been being a part of a group of people who are so pounds of vegetables to 2,500 people. Grounded in a simple premise – that active determined to do something good together.” community and cultural connections are a In addition to Allina Health and the residents of the cornerstone of good health – the Backyard One example of a CHAT accomplishment is Backyard neighborhoods, the partnership includes Initiative is a partnership between Allina Health Growing in the Backyard. Many Backyard The Cultural Wellness Center, Hope Community, and its neighbors in South Minneapolis. Since Initiative residents have raised concerns about Portico Healthnet and Twin Cities LISC. 2008, the Backyard Initiative has supported a lack of access to affordable, healthy food for residents and helped them draw upon their own their families. The Growing in the Backyard knowledge, skills and cultural values to care for themselves, their families and their neighbors. Research suggests that efforts to improve health have a greater chance of succeeding when they are

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