Date: March 21, 2013
- Sara Rosenbaum, JD, Harold and Jane Hirsh Professor, George Washington University, School of Public Health
- Kevin Barnett, DrPH, MCP, Senior Investigator, Public Health Institute
- Jean Nudelman, MPH, Director, Northern California Community Benefit Programs, Kaiser Permanente Northern California Regions
When a US hospital’s not-for-profit status is in the news, it’s usually not a good thing. It typically means someone (often a politician) is questioning whether the hospital’s federal tax exemption is deserved because of business practices, high executive pay, too little charity care, or a perceived lack of commitment to the local community. Sometimes the allegations and heightened scrutiny have been fair, sometimes not. Either way, America’s hospitals have a brand new challenge on their hands: to take newly revised IRS rules governing a hospital’s not-for-profit designation and turn them into meaningful plans to improve, in partnership with other organizations, a community’s overall health.
WIHI held a timely discussion with three leading experts on the transformation of the decades-long “community benefit” law (largely focused on hospital support for indigent patients) into something more far reaching known as Community Health Needs Assessment, or CHNA. Section 9007 of the Affordable Care Act outlined the components of CHNA, chief among them a requirement for hospitals to conduct an evaluation every three years of the health status of the neighborhoods that surround their campuses, and then to use that information to develop strategies to reduce the community’s health risks. The new IRS rules also require greater transparency in the process and obligate hospitals to work in concert with community leaders and local public health experts.
The trio of Sara Rosenbaum, Kevin Barnett, and Jean Nudelman exemplify the ways in which policy and public health expertise, access to community health data, and the experience of health care providers can combine in powerful new ways to meet the demands of CHNA — and, more importantly, to meet the demands of better health and better health care at reduced costs (yes, the good old Triple Aim).