Which hospitals participate in community building? What medical anchors spend on community economic development

Place-bound anchor institutions provide unique resources and institutional capacity to community and economic development. As such, these “eds and meds” play an increasingly important role in community economic development research and practice. Positive assessments of anchors’ contributions, however, remain limited to single-site case studies of specialty hospitals and universities with extensive resources. To deepen inquiry into anchors, we use new data, available due to recent U.S. health care policy changes, to test the impact of hospitals’ service missions and revenue sources on community economic development spending. We identify 4 basic types of hospitals: large comprehensive, specialty, neighborhood continuum of care, and regional continuum of care. Our statistical tests suggest that anchor institution activity—operationalized as community economic development spending—arises predominantly from larger, teaching-intensive hospitals. Hospital characteristics, rather than urban socioeconomic context, provide the strongest predictors of community economic development spending. These results suggest that a narrower range of urban hospitals performs community economic development. However, we discover a significant amount of hospitals in one city (Baltimore, Maryland) invested heavily in community economic development. We conclude by investigating that city’s “anchor plan” policy, which appears to have successfully channeled investment from its anchoring hospitals.