Hospital Community Benefits After the ACA: Leveraging Policies to Improve Community Health

The community health needs assessment presents opportunities for state policymakers to leverage local resources to address broader community health needs.

The Issue

The Affordable Care Act of 2010 requires nonprofit hospitals to conduct and implement a community health needs assessment (CHNA) every three years. It must address not only barriers to care and prevention of illness, but also the social, behavioral and environmental factors that influence health.

Key Findings

Multiple factors are converging to bring a national focus to population health and a major transformation in the health care delivery system. State policymakers have new opportunities to build on the framework of the CHNA in ways that improve health of the broader community, such as:

  • Build on federal rules to require electronic reporting and engagement of a broader group of stakeholders in the CHNA.

  • Promote regional collaboration to encourage hospitals to partner with local health departments, accountable care organizations (ACOs), health care providers and other organizations to minimize duplication of efforts.

  • Encourage delivery system payment reforms such as ACOs, global budgets and statewide initiatives that reward value and promote population health.

  • Invest in health information and data collection to track progress in addressing social and economic determinants of health.


State policymakers can encourage hospital leaders to partner with local health departments and other community stakeholders to address broader community health needs, creating shared value while contributing to long-term hospital sustainability.

About the Study

This RWJF-funded report is 11th in the series, Hospital Community Benefits After the ACA, by the nonprofit Hilltop Institute of the University of Maryland, Baltimore County.