Tax-Exempt Hospitals, Community Health Needs and Addressing Disparities

19 Pages Posted: 29 Jul 2012 Last revised: 31 Jul 2012

See all articles by Mary Crossley

Mary Crossley

University of Pittsburgh - School of Law

Date Written: July 26, 2012


The Affordable Care Act (ACA) imposes a number of new requirements on hospitals seeking to maintain their tax-exempt status under federal law. One requirement is that hospitals must conduct a “community health needs assessment” (CHNA) at least every three years and then develop and implement a strategy to address the needs identified in the assessment. This essay explores the potential this provision may offer for identifying, understanding, and reducing health care disparities. By calling on hospitals to focus less on individuals and more on communities, the CHNA requirement may offer a valuable addition to the toolkit for combating disparities. Thinking about hospitals and CHNAs in this fashion also contributes to a growing scholarly and professional dialogue that advocates for increased support for public health approaches to health problems and urges better integration of our public health and health care systems. This essay sketches how tax-exempt hospitals’ need to satisfy the new CHNA requirement might be harnessed as a tool for addressing health disparities, as well as some factors that might stymie this potential.

Keywords: Hospitals, Health disparities, Health care reform, Health law, Tax exemption, Community health needs, Public health, Community benefit

JEL Classification: K32, K34, I18, H20

Suggested Citation

Crossley, Mary, Tax-Exempt Hospitals, Community Health Needs and Addressing Disparities (July 26, 2012). Howard Law Journal, Vol. 55, No. 3, p. 687, 2012; U. of Pittsburgh Legal Studies Research Paper No. 2012-18. Available at SSRN:

Mary Crossley (Contact Author)

University of Pittsburgh - School of Law ( email )

3900 Forbes Ave.
Pittsburgh, PA 15260
United States
412-648-5300 (Phone)
412-648-2649 (Fax)


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