Providence Health Care, the Spokane-based nonprofit network of hospitals, physician clinics, and other health care organizations and programs, says it contributed more than $133 million last year to provide services to thousands of needy residents through Eastern Washington.

That was up sharply from $73 million in 2009.

As part of that total sum, which Providence says is the cost of services provided through what it calls its community benefit program, it provided more than $30 million worth of free and discounted care to 48,536 patients.

It says its total community benefit contribution also included:

•$76 million to cover the unfunded portion of government-sponsored medical care it provided.

•$14 million to subsidize a medical residency program, nursing education, and medical research.

•$11 million to subsidize clinical and social services provided despite operating at a financial loss.

•$2 million for community health, grants, and donations to increase access to patient education, health screenings, immunizations, and other health-related needs.

Of the $30 million worth of free and discounted care that Providence says it provided, CEO Elaine Couture says, “We have a lot of uninsured people. There were a lot of people who didn’t have insurance, or who just have other life circumstances and can’t pay the cost of care.”

Couture adds, “Most people want to pay their bills. It’s not like people expect something for nothing. That’s not what we find.”

Providence says community benefit program figures don’t include salaries, new construction, facility improvements, investments in technology, bad debt, or the taxes that it pays.

 Couture says one of the common misconceptions in the community is that Providence Health Care, as a nonprofit organization, doesn’t pay taxes, but it actually paid $63 million in taxes last year, well in excess of the $19 million tax benefit it received as a nonprofit.

Unlike the free and discounted care provided to people who show financial need, the separately calculated bad debt—for which a 2013 total wasn’t immediately available—“would be those people who just don’t pay their bills,” she says.

Couture says Providence partners with other organizations to determine how best to allocate the community benefit resources it provides, noting that it’s “part of our mission to help improve the overall health of the communities we serve.”

In a recent press release detailing Providence’s community benefit contributions last year, board Chairman Gary Livingston said, “Our region has seen a steady in the number of people who live in a state of poverty and who do not have the means to access health care. Many need preventative care, while others are acutely ill and require a variety of services to regain their health. We will continue to go to extraordinary lengths to coordinate and deliver health care where it is needed most.”

Couture predicts Providence’s community benefit contributions will continue to rise, despite the improving economy and the effects of the Affordable Care Act, which she says “doesn’t address the social determinants of health.”

“For us, it’s just kind of part of doing business,” she adds.

Regardless of the financial impacts of federal health care reform, Couture says, “We’re going to continue to stay very consistent with our mission, and our mission is to care for the poor and vulnerable.”

“Obviously, we need to be financially healthy as well,” she says, noting that Providence is looking constantly at ways to provide subsidized services more efficiently.