When it comes to hospitals serving their communities, it's more than just that. how much Hospitals spend money, how they spend it.
Therefore, hospitals are required to conduct a Community Health Needs Assessment (CHNA) every three years. These CHNAs should be developed in collaboration with the broader community with the goal of identifying priority health needs for hospitals to address in their programs. In this way, hospital spending on community health programs will be targeted to the areas that have the greatest impact on improving health.
Sounds like a great system, but unfortunately things don't always go as planned. Here's what research shows about CHNA quality and his CHNA impact on community health spending.
Fair Share Spending, Community Investment, CHNA
Non-profit hospitals are exempt from taxes. In return, they are expected to invest back into the community. However, there are few regulations that ensure adequate returns. In fact, research from the Loan Institute shows that many hospitals are not adhering to the end of this social contract, resulting in a $25.7 billion fair share deficit.
Even if hospitals are required to spend more on community investments, we still need them to direct those investments to where they are needed most. In theory, CHNA is perfect for this, letting hospitals know exactly where to focus their resources. But in reality, the effectiveness of that support depends on both the strength of his CHNA and his commitment to community investment.
The quality of CHNA varies by hospital.
The IRS requires hospital facilities to complete the following steps when conducting a CHNA:
- Define the community you will serve.
- Assess the health needs of that community.
- When assessing the health needs of a community, seek and take into account input received from people representing the broader interests of the community, including those with special knowledge or expertise in public health. .
- Document the CHNA in a written report adopted for the hospital facility by the hospital facility's accrediting agency.
- Make the CHNA report widely available to the public.
The extent to which hospitals achieve these five goals and involve community groups varies. 2021 Review of 500 Hospitals CHNA Japan Automobile Manufacturers Association We found that 42% did not include an assessment of the impact statement and 25% did not list resources available to address the identified health needs. In another study in 2023, CHNA community feedback included “more women, whites, college graduates, older adults” and “study recruitment included people without internet access, people who were illiterate,” It was found that “those who did not have or were unable to speak were not included.” I speak English fluently. ”
And in a series of interviews with community organizations, they found that, “While many hospitals engaged and involved community stakeholders in specific aspects of the evaluation process, they also It was found that “few hospitals meaningfully engaged members of the
Done correctly, CHNA can be used not only as a tool to facilitate connections, but also as a tool to guide progress.
Fortunately, some states provide additional guidance and requirements for hospitals and specify the types of local groups or government agencies that must be involved in the CHNA process. On the plus side, there is also an opportunity to build trust and relationships between the community and the hospital, as the hospital actively invites the community for collaboration. Done correctly, CHNA can be used not only as a tool to facilitate connections, but also as a tool to guide progress.
Weak connection between CHNA and community investment
Even if a hospital does a great job of creating a CHNA, there is no guarantee that the hospital will target the health needs identified in the document. That's because there are no federal regulations requiring nonprofit hospitals to spend a minimum amount on health needs identified in the CHNA. Hospitals are responsible for allocating resources as needed. As a result, we found that the link between CHNA findings and community investment was weakened, and opportunities to improve community health were significantly missed.
We feature CHNA from Parkview Medical Center in Pueblo, Colorado. Their CHNA indicated that the most important health needs for the community are 1) access to care, 2) alcohol and other drug use, and 3) ease of access to information. Ta. Their stated solution to these problems was to develop a telemedicine app and create a series of preventive health videos. These small efforts ring hollow to some Pueblo residents, who have faced high medical debt and watched Parkview close its inpatient psychiatric unit. KFF Health News Residents are reportedly organizing to get Parkview and other local hospitals to participate in community benefit spending.
If done correctly, hospitals can meaningfully act on CHNA findings and truly bring communities together. For example, Rush University Medical Center has published an extensive framework outlining the CHNA process, implementation plan, and outcomes. By highlighting findings of racial disparities in breast cancer mortality and then emphasizing community partnerships to address this disparity, the medical center and community partners will 20% (from 51% to 41%), a result not seen in any other American city studied. ”
CHNA has the potential to identify health needs, guide hospital administrators and clinicians where to focus their efforts, and foster trust and connection between health care workers and community members. Done right, it can be an essential tool in building the just and compassionate health system we need and deserve.
