Cleveland Clinic Provides $907M in Community Benefit

In 2017 Cleveland Clinic provided $906.5 million in community benefit – including financial assistance, Medicaid shortfall, subsidized health services, outreach programs, education and research – the highest level in our reporting history.

The total – a 5 percent increase over 2016 – ­includes all health system operations in Ohio, Nevada and Florida.

“Cleveland Clinic is committed to creating healthier communities,” said Tom Mihaljevic, M.D., CEO and president of Cleveland Clinic. “Our community benefit is far-reaching, including healthcare access for everyone in our communities; the education of the next generation of healthcare professionals; free prevention and screening programs; and medical research that leads to advanced treatments and cures.”

Cleveland Clinic calculates community benefit conforming to the IRS Form 990 reporting guidelines, which include activities or programs that improve access to health services, enhance public health, advance general 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 ($90 million)

Financial assistance increased 4 percent over 2016 and includes free or discounted care provided to patients who are 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.

Medicaid shortfall ($406.9 million)

Medicaid provides government-funded healthcare coverage for low-income families and individuals. However, in many states, including Ohio, Medicaid payments do not sufficiently cover the costs of treating Medicaid beneficiaries. In 2017, Cleveland Clinic’s Medicaid costs were $406.9 million – a 7.1 percent increase over 2016 – including an $8.3 million net contribution to Ohio’s Hospital Care Assurance Program (HCAP). (The 2016 Medicaid shortfall has been revised upward to properly reflect costs which were previously understated.)

Subsidized services ($22 million)

These are clinical services provided to meet the needs of the community despite creating a financial loss for the hospital system, such as behavioral health, obstetric and chronic disease management, among others. The 2017 total represents a 12.4 percent increase from 2016.

Health professions education ($280.9 million) and research ($70.6 million)

Costs for training health professionals – medical residents, fellows, nurses and allied health professionals – increased 3.2 percent from 2016 to 2017, while research expenses increased 10.3 percent.

Outreach programs ($36.1 million)

Cleveland Clinic’s outreach programs align with the local needs identified in the hospitals’ Community Health Needs Assessments, with an emphasis on prevention, wellness and chronic disease management. Examples include:

• The Stephanie Tubbs Jones Family Health Center provides programs which teach community members about prevention, wellness, nutrition and behavioral modification. Navigation services connect community members with support programs.
• Community classes and interactive web chats offer health education on chronic disease management in the areas of heart disease, stroke, cancer, diabetes, asthma, brain health, and healthy senior and youth lifestyles.
• The Healthy Community initiatives connect residents with local resources in a collaborative effort to strengthen communities through wellness activities, academic achievement and career preparedness.
• Health fairs – including the Cleveland Clinic Minority Men’s Health Fair, Celebrating Sisterhood, Tu Familia, Victory in Pink, and neighborhood fairs – provide thousands of people with free health screenings and educate community members on the benefits of preventive healthcare.
• Collaborative initiatives with community nonprofits and local government address population health issues, such as the opioid crisis and infant mortality.

As a nonprofit hospital system, Cleveland Clinic is a community asset with no owners, investors or stockholders. Any and all extra funds from operations are invested back into the health system to support patient care, research, education, and long-standing charitable efforts.

Read or download the entire report here.