scholarly journals US Nonprofit Hospitals’ Community Health Needs Assessments and Implementation Strategies in the Era of the Patient Protection and Affordable Care Act

2021 ◽  
Vol 4 (8) ◽  
pp. e2122237
Author(s):  
Leo Lopez ◽  
Meera Dhodapkar ◽  
Cary P. Gross
Keyword(s):  
Community Health ◽  
Affordable Care Act ◽  
Implementation Strategies ◽  
Health Needs ◽  
Nonprofit Hospitals ◽  
Needs Assessments ◽  
Patient Protection

Health Education Careers in a Post–Health Reform Era

2017 ◽  
Vol 18 (5) ◽  
pp. 629-635 ◽  
Author(s):  
M. Elaine Auld
Keyword(s):  
Health Education ◽  
Affordable Care Act ◽  
Preventive Health Services ◽  
Public Understanding ◽  
Business Practices ◽  
Nonprofit Hospitals ◽  
Reform Era ◽  
Needs Assessments ◽  
Patient Protection ◽  
The Individual

Since enactment of the Patient Protection and Affordable Care Act in 2010, health education specialists (HES) have made important contributions in implementing the law’s provisions at the individual, family, and population levels. Using their health education competencies and subcompetencies, HES are improving public understanding of health insurance literacy and enrollment options, conducting community health needs assessments required of nonprofit hospitals, modifying policies or systems to improve access to health screenings and preventive health services, strengthening clinical and community linkages, and working with employee benefit plans. In addition to educating stakeholders about their complementary training and roles with respect to clinical providers, HES must keep abreast of rapid changes catalyzed by the Affordable Care Act in terms of health standards, payment models, government regulations, statistics, and business practices. For continued career growth, HES must continually acquire new knowledge and skills, access and analyze data, and develop interprofessional partnerships that meet the evolving needs of employers as the nation pursues health for all.

State-Level Community Benefit Regulation and Nonprofit Hospitals' Provision of Community Benefits

2018 ◽  
Vol 43 (2) ◽  
pp. 229-269 ◽  
Author(s):  
Simone R. Singh ◽  
Gary J. Young ◽  
Lacey Loomer ◽  
Kristin Madison
Keyword(s):  
Community Health ◽  
State Level ◽  
Health Needs ◽  
Charity Care ◽  
Nonprofit Hospitals ◽  
Community Benefit ◽  
Minimum Income ◽  
Needs Assessments ◽  
Community Benefits ◽  
Eligibility Standards

Abstract Do nonprofit hospitals provide enough community benefits to justify their tax exemptions? States have sought to enhance nonprofit hospitals' accountability and oversight through regulation, including requirements to report community benefits, conduct community health needs assessments, provide minimum levels of community benefits, and adhere to minimum income eligibility standards for charity care. However, little research has assessed these regulations' impact on community benefits. Using 2009–11 Internal Revenue Service data on community benefit spending for more than eighteen hundred hospitals and the Hilltop Institute's data on community benefit regulation, we investigated the relationship between these four types of regulation and the level and types of hospital-provided community benefits. Our multivariate regression analyses showed that only community health needs assessments were consistently associated with greater community benefit spending. The results for reporting and minimum spending requirements were mixed, while minimum income eligibility standards for charity care were unrelated to community benefit spending. State adoption of multiple types of regulation was consistently associated with higher levels of hospital-provided community benefits, possibly because regulatory intensity conveys a strong signal to the hospital community that more spending is expected. This study can inform efforts to design regulations that will encourage hospitals to provide community benefits consistent with policy makers' goals.

Defining “Community” in Community Health Evaluation

2017 ◽  
Vol 39 (2) ◽  
pp. 237-256 ◽  
Author(s):  
Berkeley A. Franz ◽  
Daniel Skinner ◽  
John W. Murphy
Keyword(s):  
Community Health ◽  
Evaluation Research ◽  
Health Needs ◽  
Health Evaluation ◽  
Community Based ◽  
Nonprofit Hospitals ◽  
Needs Assessments ◽  
Geographic Boundaries ◽  
Bounded Group ◽  
History Of

This article examines the theoretical basis of the community as it is evoked in health evaluation. In particular, we examine how hospitals carrying out Community Health Needs Assessments (CHNAs) define communities as well as the implications for these definitions for how to study and engage community problems. We present qualitative findings from a sample of Appalachian nonprofit hospitals, who we asked to describe their approach to defining the community in their most recent Internal Revenue Service–mandated CHNA. Drawing upon a theoretical debate in the history of evaluation research, the authors argue that the contemporary community cannot be circumscribed merely by geographic boundaries, nor can it be identified easily with a bounded group of clearly demarcated individuals. Instead, following the tenets of community-based health research, the authors argue for a richer, more dynamic conceptualization of the community in evaluation research in which definitions arise from community bodies themselves.

scholarly journals Indiana Nonprofit Hospitals’ Community Health Needs Assessments Objectives and Evaluation

2020 ◽  
Vol 3 ◽  
Author(s):  
Kevin Walters ◽  
Dennis Savaiano
Keyword(s):  
Health Outcomes ◽  
Community Health ◽  
Population Health ◽  
The United States ◽  
Health Needs ◽  
High Quality ◽  
Nonprofit Hospitals ◽  
Community Benefit ◽  
Needs Assessments

Background/Objective:   Over half of the hospitals in the United States are not for profit and confer large tax advantages so long as they demonstrate community benefit. Since 2010 these hospitals have been required by law to conduct Community Health Needs Assessments (CHNAs) in order for community benefit to move from charity care to improved population health outcomes. For improved population health outcomes, we argue that effective community health programs must be put into place with high quality goals and evaluations to ensure effectiveness. We rated the objectives and evaluation plans of Indiana nonprofit hospitals’ CHNAs and then compared and correlated the quality of these plans with characteristics of the hospitals and health indicators of their community.      Methods:  CHNAs and Implementation Plans were obtained for 95 nonprofit hospitals in Indiana. The assessments and plans were independently scored by 2 assessors based on specific criteria for quality using a Likert scale which ranged from 0 to 5. We averaged the scores and then correlated and compared them to characteristics of the hospital, its local partnerships, and the health statistics of the communities in which they reside.    Results:  The average score for the objectives was 3.43 and for the evaluation 2.47 with large variations in the criteria met by each hospitals CHNA. Significant differences were found between the scores of system-based and independent hospitals for both evaluation and objectives (p=0.01, p<0.001).     Conclusion and Potential Impact:  Our data shows that the quality of CHNAs’ objectives and evaluation is universally poor and vary greatly from hospital to hospital. However, consistency and to a lesser degree quality of scores can be affected by system wide models. If the goal of these assessments is to create better population health outcomes through nonprofit hospitals, then the government needs to provide a high-quality model for hospitals to follow.  

scholarly journals The Magnitude of a Community’s Health Needs and Nonprofit Hospitals’ Progress in Meeting Those Needs: Are We Faced With a Paradox?

2017 ◽  
Vol 133 (1) ◽  
pp. 75-84 ◽  
Author(s):  
Simone R. Singh ◽  
Geri R. Cramer ◽  
Gary J. Young
Keyword(s):  
Community Health ◽  
Physical Environment ◽  
Multivariate Analyses ◽  
Health Needs ◽  
Nonprofit Hospitals ◽  
Community Benefit ◽  
Needs Assessments ◽  
Access To Medical Care ◽  
Operational Plan ◽  
Comprehensive Indicator

Objectives: Although most nonprofit hospitals are required to conduct periodic community health needs assessments (CHNAs), such assessments arguably are most critical for communities with substantial health needs. The objective of this study was to describe differences in progress in conducting CHNAs between hospitals located in communities with the greatest compared with the fewest health needs. Methods: We used data on CHNA activity from the 2013 tax filings of 1331 US hospitals combined with data on community health needs from the County Health Rankings. We used bivariate and multivariate analyses to examine differences in hospitals’ progress in implementing comprehensive CHNAs using 4 activities: (1) strategies to address identified needs, (2) participation in developing community-wide plans, (3) including CHNA into a hospital’s operational plan, and (4) developing a budget to address identified needs. We compared progress in communities with the greatest and the fewest health needs using a comprehensive indicator comprising a community’s socioeconomic factors, health behaviors, access to medical care, and physical environment. Results: In 2013, nonprofit hospitals serving communities with the greatest health needs conducted an average of 2.5 of the 4 CHNA activities, whereas hospitals serving communities with the fewest health needs conducted an average of 2.7 activities. Multivariate analysis, however, showed a negative but not significant relationship between the magnitude of a community’s health needs and a hospital’s progress in implementing comprehensive CHNAs. Conclusions: Hospitals serving communities with the greatest health needs face high demand for free and reduced-cost care, which may limit their ability to invest more of their community benefit dollars in initiatives aimed at improving the health of the community.

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