Question: Our hospital maintains a mammography van that goes into the community — venues can be churches, community center, employers — to offer mammograms to both insured and uninsured women. We are having a hard time determining what can be counted as a community benefit. To date, we have only counted as community benefit expense the staff time at the site and not the cost of the operating the van. However, most of these mammograms are covered by insurance or grants. It is predominantly a service of convenience for insured women and a means of diagnosis and follow-up care for the indigent. Although it serves more insured than uninsured patients, it is still a financial loss to the hospital.
Recommendation: To determine if this service qualifies as a subsidized service it will be important to ask "if we did not provide it would there be a shortage of this service to meet an identified health need in the community?" If there isn't a shortage of providers, are there other aspects of offering this service that makes it unique to a special population? If you responded yes to either of these two questions the expenses for the service may be reported in Category C3, "Subsidized Health Services."
If the program does not qualify to be reported in the C3 category, you may report free and discounted services as charity care.