One of the Obamacare provisions that has the potential to change our communities for the better is not getting much attention in the media. The Affordable Care Act (ACA) includes a requirement for nonprofit hospitals to conduct a community health needs assessment (CHNA) at least once every three years. This is important to all of us. How our hospitals and other health partners respond could be a game-changer for our communities.
Under the new requirement , nonprofit hospitals must complete an analysis of data and information to identify and prioritize community health needs. The CHNA must take into account input from agencies, experts, and members of the community. Then the hospitals must adopt strategies to address each of the community health needs identified through the CHNA. If they do not include all of the identified health needs in their plan, they must explain why not. If hospitals don’t comply, they will be subject to a $50,000 excise tax per facility and may lose their tax-exempt status.
Unfortunately, one of the most important parts of the guidance for a CHNA did not make it into the “must” column. Hospitals “may” conduct the CHNA in collaboration with other organizations such as other hospitals, local public health departments, and others. Collaboration is a good thing!
Some hospitals in Michigan have been involved in community health assessment and improvement efforts dating back to the early 1990s, when local public health departments were required and funded to complete a similar process. At that time the local health departments were the ones encouraged to engage a broad stakeholder group, including hospitals. As funding for local public health has been cut, community health assessment and improvement efforts have shriveled. Now the ACA is giving new life to community-wide health assessment and improvement by requiring hospitals to invest in the process and encouraging collaboration.
The potential benefits for the hospitals and the community are huge. The CHNA—and the community perspectives and priorities that are central to the process—can be used to shape the community benefit programs that nonprofit hospitals have long been required to provide. This will ensure that hospital resources are targeted effectively and provide value to community members—a win-win. And as community partners come together to collaborate on the CHNA, they will all benefit from a shared understanding of the needs and resources in the community and be able to make decisions regarding their own services that match community priorities and make the best use of their own limited resources. Community members will benefit, too, from a more coordinated approach to the planning and delivery of services—a win-win-win. In my experience, collaborative efforts always have unanticipated, far-reaching benefits because of the relationships that are formed and strengthened as people meet, communicate, and work together to solve shared problems. So we all win!
By Jane Powers