Table 1.

Within‐hospital differences in community benefit spending relative to alternative control groups, 2011‐2015

Community benefit type	Charity care	Public payer shortfall	Community health activities	Health professions education	Subsidized medical care	Cash donations	Research	Total community benefits
Panel A: New participants compared to all other hospitals (N = 2719)
Ln(Expenditures)	0.218	0.211	0.153	0.229	0.006	−0.236	−0.367	0.008
SE	[0.098]	[0.497]	[0.112]	[0.120]	[0.159]	[0.182]	[0.338]	[0.049]
P‐value	0.026	0.671	0.171	0.056	0.971	0.195	0.278	0.870
Pr(Expenditures > 0)	0.004	0.037	0.002	0.025	−0.055	−0.070	−0.008	−0.003
SE	[0.006]	[0.030]	[0.026]	[0.024]	[0.030]	[0.038]	[0.030]	[0.010]
P‐value	.508	.217	.927	.282	.068	.064	.776	.786
Panel B: New participants compared to nonparticipants (N = 2704)
Ln(Expenditures)	0.289	0.141	0.150	0.212	0.111	−0.287	−0.293	0.004
SE	[0.088]	[0.519]	[.099]	[0.116]	[0.136]	[0.191]	[0.274]	[0.059]
P‐value	.001	.787	.133	.067	.413	.134	.287	.945
Pr(Expenditures > 0)	0.003	0.0184	0.018	0.014	−0.063	−0.074	−0.038	0.003
SE	[0.004]	[0.033]	[0.024]	[0.024]	[0.031]	[0.037]	[0.032]	[0.010]
P‐value	.495	.579	.446	.555	.041	.044	.239	.802
Panel C: New participants compared to not‐yet participants (N = 722)
Ln(Expenditures)	0.213	0.309	0.145	0.191	−0.087	−0.428	−0.673	0.013
SE	[0.098]	[0.492]	[0.112]	[0.152]	[0.175]	[0.195]	[0.298]	[0.060]
P‐value	.031	.532	.197	.212	.619	.030	.030	.829
Pr(Expenditures > 0)	0.008	0.027	0.026	0.064	−0.022	−0.064	0.004	0.007
SE	[0.006]	[0.034]	[0.027]	[0.032]	[0.036]	[0.038]	[0.032]	[0.009]
P‐value	.162	.428	.337	.043	.543	.098	.891	.466

The table presents estimates from a difference‐in‐differences model as specified in Equation 1. All community benefit outcomes are measured in logs or as indicators of nonzero expenditures. They include the following: charity care, defined as care provided to patients as part of a formal charity care plan; public payer shortfall, defined as the difference between costs of treating Medicaid and other patients covered by state and local programs less revenues for treating those patients; community health improvements, defined as nonmedical community activities to improve health such as health fairs; health professions education, defined as spending on training such as nurse education; subsidized medical care, defined as free or reduced priced medical care provided outside of the hospital's charity care program, such as a patient drug assistance program. Total represents the total across all categories. All expenditures were measured net of off‐setting revenues and were winsorized at the 1st and 99th percentiles. The dependent variable is specified as the fraction of hospitals in the hospital system that are eligible for 340B. Panel A compares hospitals that begin participating in 340B between 2012 and 2015 to all other hospitals. Panel B compares hospitals that begin participating in 340B between 2012 and 2015 to a group of reweighted nonparticipating hospitals using average treatment on the treated propensity scores. Panel C uses not‐yet participating hospitals that begin participating in 340B between 2012 and 2015 to those that are currently not participating but participate eventually after 2015 when our sample ends. All estimates are generated using ordinary least squares. Cluster‐robust standard errors are presented below each estimate and are displayed below in brackets. Panels A and B include hospital and state‐year fixed estimates. Panel C includes only hospital and year fixed estimates.