Kevin Barnett, PhD, is Senior Investigator at the Public Health Institute. Catherine Craig, MPA, MSW, has served as IHI Triple Aim faculty since 2009.
Hospital and health system leaders in today’s world confront a blizzard of daily decisions. They manage innumerable near-term crises and make long-term bets based upon complex, but often incomplete information. And now they face a relatively new category of decisions: how hospitals build shared ownership for health with diverse stakeholders.
More and more, the policy environment is offering opportunities to improve population health through cooperative, coordinated efforts. The Affordable Care Act (ACA) and the move to value-based reimbursement provides the impetus and incentive to keep people healthy and out of inpatient acute care settings. The IRS reporting requirements — that tax-exempt hospitals create Community Health Needs Assessments (CHNAs) — provide a framework for evaluating health in communities, setting priorities, and taking action. The goal is for hospitals to use what they learn during the assessment process to focus their efforts where the community most needs it.
How can you make the most of your CHNA? Here are three tips to help you turn your CHNA into action:
- Search for existing data — When creating needs assessments, some hospitals forget to take the time to identify community stakeholders who regularly collect information on health needs, social needs, and drivers of poor health outcomes. Public health departments, social service organizations, schools, and competing health care organizations have their own storehouses of data. An effective CHNA will encompass the needs and assets of the community, with data drawn from multiple sources, not limited to a stand-alone hospital survey.
- Don’t get stuck in a “compliance” mentality — It’s easy to fall into the trap of viewing the completion of a CHNA as just a box we need to check off. A quickly dispatched CHNA may meet minimum requirements, but when hospitals work on CHNAs in isolation, they are unlikely to help an organization improve community health. It may seem efficient to delegate CHNAs to a separate department, but well-aligned approaches that leverage the expertise of a diverse corps of hospital leadership can ensure that needs are translated into coordinated health improvement activities, underscore strategic goals, and ready hospitals for value-based payment.
- Don't go it alone — In this emerging reality, a growing number of hospitals view community benefit as an engine for transformation. Many are already working with others to develop evidence-based solutions to address near-term challenges in care management for patient populations. Some are beginning to move to the next level by working across sectors to address the social determinants of health. And still others are reaching across the table to partner with long-time competitor hospitals. Look to the bright spots to learn how others leverage the resources and expertise of hospitals and effectively mobilize the wide array of assets in their communities.
You’ll spend a lot of time and effort completing your CHNAs. Why not use this mandate to strategically build the relationships, skills, and knowledge necessary to truly meet the needs of your community?
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