AcademyHealth Annual Research Meeting: Hospital Community Benefit

Jun 26, 2013, 11:45 AM

Under the Affordable Care Act, tax-exempt hospitals are now required to conduct a community health needs assessment at least every three years and develop an implementation strategy to tackle the needs identified by the assessment.

At this week’s AcademyHealth meeting in Baltimore, experts moved from the “guess what you have to do” approach to community benefit heard at some public health meetings to some practical strategies hospitals can follow not only to fulfill the letter of the law, but to actually improve community health.

Peter Sartorius, community benefit director of the Muskegon (Michigan) Community Health Project, which brings together several Mercy hospitals in the region, told the audience that costs of the requirement can range from about $12,000 for a staff person to conduct the needs assessment to about $65,000 if a consultancy, such as a public health institute, does the work. Mercy requires that the County Health Rankings, developed through a collaboration of the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, be used by the hospitals in its network as the baseline measures of community health.

Sartorius urged hospitals to choose “collaborative partners” such as community health clinics, United Way agencies and universities, who can help develop the assessment and report and also share in the cost. Others have said that community benefit also offers a ripe opportunity for collaboration between hospitals and public health departments, which already house a lot of data and have similar community needs assessment requirements for voluntary accreditation.

Recommendations for input into the report include demographics and results of consumer surveys, community conversations and focus groups. Muskegon’s community needs assessment included “talking circles”—“a coming together of people for a special purpose”—with both physicians and Native Americans. Talking circles, among other things, assume respect among all participants for the viewpoints of others. A key suggestion from Sartorius: “Start early. The process takes twice as long as you think.”

Abbie Yant of St. Francis Memorial Hospital in San Francisco says a coalition in that city, Building a Healthier San Francisco, has created more than 100 partnerships. “We’re embracing collective impact to improve community health.” Yant says the entities came together to share resources and the assessment was done based on three values: alignment of resources, priorities and action; community connections to support health and well being; and health equity through planning and service delivery.

Yant says alignment of resources also involves figuring out how the group stays organized to make a difference. “After the needs assessment we need to stay at the table or the work may be forgotten once the report is done. We’re working on how to remain impactful.”

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This commentary originally appeared on the RWJF New Public Health blog.