Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro.
Center for Public Health Practice and Research, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro.
JAMA Netw Open. 2021 Jul 1;4(7):e2117791. doi: 10.1001/jamanetworkopen.2021.17791.
In 2016, Georgia implemented the Rural Hospital Tax Credit Program, which allows taxpayers to receive a tax credit for contributions to qualifying rural hospitals in the state. Empirical evidence of the program's association with the viability of the state's rural hospitals is needed.
To examine the association of the tax credit program with the financial health of participating rural hospitals.
DESIGN, SETTING, AND PARTICIPANTS: This longitudinal cross-sectional study used hospital financial data from the Centers for Medicare & Medicaid Services for 2015 to 2019. A difference-in-differences analytic approach was used to examine the association of the tax credit program with rural hospital financial health. Study participants included Georgia rural hospitals eligible to participate in the program. Comparison hospitals were selected from the southern states of Alabama, Florida, Mississippi, North Carolina, South Carolina, and Tennessee.
Hospital participation in the Georgia Rural Hospital Tax Credit Program.
The primary outcome of the study was financial health measured with total margin, days cash on hand, debt-asset ratio, and average age of plant as well as a Financial Strength Index (FSI), which combined the previous measures to assess overall financial strength.
The analytical sample included a balanced panel of 136 hospitals, with 47 Georgia Rural Hospital Tax Credit Program participants (18 [38%] critical access hospitals; 5 [11%] system affiliated; mean [SD] bed count, 60 [47]; mean [SD] Medicare inpatient mix, 52% [16]) and 89 comparison hospitals (43 [48%] critical access hospitals; 24 [27%] system affiliated; mean [SD] bed count, 52 [41]; mean [SD] Medicare inpatient mix, 67% [18]). Two years after implementation, program participation was associated with a 23% increased probability of good or excellent financial health (b = 0.23; 95% CI, 0.10-0.37; P < .001) and a 6.7-point increase in total margin (b = 6.67; 95% CI, 3.61-9.73; P < .001).
These early findings suggest that the Georgia Rural Hospital Tax Credit Program is associated with improvements in hospital financial health; however, additional studies are needed to assess the program's long-term impact on the financial sustainability of Georgia's rural hospitals.
2016 年，佐治亚州实施了农村医院税收抵免计划，该计划允许纳税人因向该州符合条件的农村医院捐款而获得税收抵免。需要实证证据来证明该计划与该州农村医院的生存能力之间的关联。
研究税收抵免计划与参与农村医院财务健康状况之间的关联。
设计、地点和参与者：本纵向病例对照研究使用了医疗保险和医疗补助服务中心 2015 年至 2019 年的医院财务数据。采用差异中的差异分析方法来检验税收抵免计划与农村医院财务健康状况之间的关联。研究参与者包括有资格参加该计划的佐治亚州农村医院。对照医院是从阿拉巴马州、佛罗里达州、密西西比州、北卡罗来纳州、南卡罗来纳州和田纳西州等南部州选择的。
医院参与佐治亚州农村医院税收抵免计划。
该研究的主要结果是用总利润率、手头现金天数、债务资产比率和设备平均年龄以及财务实力指数（FSI）来衡量财务健康状况，FSI 结合了以前的措施来评估整体财务实力。
分析样本包括 136 家医院的平衡面板，其中 47 家佐治亚州农村医院税收抵免计划参与者（18 家[38%]为农村医疗补助医院；5 家[11%]为系统附属；平均[标准差]床位数，60[47]；平均[标准差]医疗保险住院患者混合比例，52%[16]）和 89 家对照医院（43 家[48%]为农村医疗补助医院；24 家[27%]为系统附属；平均[标准差]床位数，52[41]；平均[标准差]医疗保险住院患者混合比例，67%[18]）。实施两年后，计划参与与良好或优秀财务健康状况的概率增加了 23%（b=0.23；95%CI，0.10-0.37；P<0.001），总利润率增加了 6.7 个百分点（b=6.67；95%CI，3.61-9.73；P<0.001）。
这些早期发现表明，佐治亚州农村医院税收抵免计划与医院财务健康状况的改善有关；然而，需要进一步的研究来评估该计划对佐治亚州农村医院财务可持续性的长期影响。
