// Deduction

Hospital delivery system reform incentive payments

B&O Tax deduction · RCW 82.04.43395(2)(b) · enacted 2018

All exemptions & deductions

Details

Citation
RCW 82.04.43395(2)(b)
Study reference
E1152-1
Tax type
B&O Tax
Preference type
Deduction
Category
Nonprofit
Year enacted
2018
End date
None scheduled

Fiscal impact (2024 study estimates)

Revenue if repealed — local ($M)
FY 2024: 0 · FY 2025: 0 · FY 2026: 0 · FY 2027: 0
Revenue if repealed — state ($M)
FY 2024: 0 · FY 2025: 0 · FY 2026: 0 · FY 2027: 0
Taxpayer savings — local ($M)
FY 2024: 0 · FY 2025: 0 · FY 2026: 0 · FY 2027: 0
Taxpayer savings — state ($M)
FY 2024: 0 · FY 2025: 0 · FY 2026: 0 · FY 2027: 0

CTI = confidential taxpayer information · D = unable to disclose

From the 2024 DOR Tax Exemption Study

82.04.43395(1) - Accountable communities of health Description Accountable Communities of Health (ACHs) may take a B&O tax deduction for Medicaid delivery system reform incentive payments and transformation project funding distributed by the Health Care Authority (HCA) through Medicaid demonstration project number 11-W-00304/0. The Centers for Medicare and Medicaid Services (CMS) approved the project in accordance with Sec. 1115(a) of the Social Security Act. The Patient Protection and Affordable Care Act allows for CMS to approve demonstration projects giving states flexibility to design and improve their Medicaid programs. These projects intend to demonstrate and evaluate state- specific experimental policy approaches to determine whether there are alternative means to better serve Medicaid populations. Projects must be budget neutral to the Federal Government. For the purposes of this deduction, an ACH is a regional nonprofit designated by the HCA to work together with the health care delivery system, health plans, public health, social services, community-based organizations, the justice system, schools, tribal partners, and local government leaders to improve the health equity

Does this apply to you?

This is reference data from the 2024 study — not advice, and 2025–26 legislation may have changed it. Three ways to go deeper: