When Cleveland Clinic was founded in 1921, nonprofit hospitals were not required to provide charitable care. Yet, founding physicians Frank Bunts, MD, George Crile, MD, William Lower, MD, and John Phillips, MD, knew they had a responsibility to the community they served.
Early on, they took the risk of personally underwriting Cleveland Clinic’s debts in order to establish a nonprofit foundation dedicated to research, medical education and community service.
Their commitment resonates today. Cleveland Clinic remains a community asset without owners, investors or stockholders. Any and all extra funds from operations are invested back into the health system to support new research and education initiatives and to continue the organization’s long-standing charitable efforts.
In 2009, annual community benefit reporting for nonprofit hospitals became mandatory. In addition, the Affordable Care Act of 2012 requires nonprofit hospitals to provide a community health needs assessment (CHNA) process that must include planning, prioritization and implementation strategies to guide hospital investment. View Cleveland Clinic’s 2016 CHNA here.
A Record Amount
In 2016, Cleveland Clinic provided $809 million in community benefit in Ohio, Nevada and Florida, a 17 percent increase over 2015 and the highest level of community benefit in its reporting history. Read the full Community Benefit Report here.
Cleveland Clinic calculates community benefit conforming to the IRS Form 990 guidelines. Community benefit includes activities or programs that improve access to health services, enhance public health, advance generalizable knowledge and relieve government burden.
The primary categories for assessing community benefit include financial assistance, Medicaid shortfall, subsidized health services, outreach programs, education and research:
Financial assistance — $86.2 million
Financial assistance is the amount of free or discounted medically necessary care provided to those patients unable to pay some or all of their bills. Cleveland Clinic’s financial assistance policy provides free or discounted care to patients with incomes up to 400 percent of the federal poverty level and covers both hospital care and our employed physician services.
Medicaid shortfall — $328.5 million
The Medicaid program, which provides healthcare coverage for low-income families and individuals, is funded by state and federal governments. In many states, including Ohio, Medicaid payments have not been sufficient to cover the costs of treating Medicaid beneficiaries. In 2016, Cleveland Clinic experienced a 35 percent increase in Medicaid shortfall compared to 2015.
Subsidized health services — $19.6 million
Subsidized health services are clinical services provided to meet the needs of the community despite creating a financial loss. Subsidized health services within Cleveland Clinic include pediatric programs, psychiatric/behavioral health programs, obstetrics services, chronic disease management and outpatient clinics.
Outreach programs — $38.1 million
Cleveland Clinic’s outreach programs are designed to serve the most vulnerable and at-risk populations as identified in our comprehensive Community Health Needs Assessments.
Programs range from free wellness initiatives, health screenings, clinical services and education to enrollment assistance for government-funded health programs.
In 2016, highlights included:
- Wellness initiatives in the areas of disease/injury prevention and behavioral change, including tobacco cessation, nutrition improvement, exercise, substance abuse, child safety, teen parenting and domestic violence. Programs were provided to schools, faith-based organizations, community centers, and collaborating cities and counties.
- Health fairs provided thousands of people with free health screenings, including the Cleveland Clinic Minority Men’s Health Fair, Celebrating Sisterhood, Tu Familia and neighborhood preventive health fairs.
- Cleveland Clinic provided no-cost clinical and wellness services to under- and uninsured families at community sites, including Langston Hughes Health & Education Center and our pediatric mobile unit. Laboratory and vision services were donated to Cleveland-area organizations.
- Collaborative initiatives with community nonprofit organizations and local governments addressed critical population health issues, including the opioid epidemic and infant mortality.
Education — $272.3 million
Cleveland Clinic takes pride in a wide range of high-quality medical education that includes accredited training programs for residents, physicians, nurses and allied health professionals. By educating medical professionals, we ensure that the public is receiving the highest standard of medical care and will have highly trained health professionals to care for them in the future.
Research — $64 million
Research into diseases and their cures is an investment in people’s long-term health. From a community benefit standpoint, research includes basic, clinical and community health research, as well as studies on healthcare delivery. Cleveland Clinic’s Lerner Research Institute is continually bringing medical advances into patient care and to the medical world through the development of new techniques, devices and treatment protocols. Over 1,900 scientists and support personnel, including 179 principal investigators, are providing research at Cleveland Clinic.