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A new study of hospitals’ charity care spending suggests nonprofit hospitals really aren’t that different from their for-profit counterparts.

One major benefit of being a nonprofit hospital is receiving tax exemptions on property taxes, income taxes, and sales taxes. Experts told STAT that implies a “social contract” with taxpayers, where these hospitals will help take care of the most vulnerable. But according to a new study, 80% of 2,425 nonprofit hospitals spent less on charity care and community investment than they got in estimated tax breaks.

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The new study underscores the gap between the general public’s perception of the “social largesse” of nonprofit hospitals and those organizations’ actual behavior, said Genevieve Kanter, an associate professor of public policy at the University of Southern California who was not involved in the study.

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