The Hidden Opportunity in Community Health

community health needs assessment

Your hospital’s community health needs assessment (CHNA) represents more than just number crunching, statistics and red tape.

However, if you’re like me, your local hospital’s CHNA probably didn’t make it into your beach bag over the summer – the reports are full of data and cover problems that seem outside the hospital’s scope to solve.

But don’t be fooled.

Community health needs assessments and the process used to develop them can provide you with invaluable data and a powerful pathway to engage and partner with your community.  Alternatively, a hospital in Texas recently lost its non-profit status after it failed to comply with the requirement to develop a CHNA, the Healthcare Financial Management Association reported.

Not only did this hospital risk its reputation and financial health, it missed out on an opportunity to position itself as committed to and engaged with the community it serves—something that would surely help as it addresses the fallout of its decision.

Some background: CHNAs have been around for decades, but as of 2011, every non-profit hospital or health system must develop one for each of its communities. Smart systems leverage this requirement and the resulting report(s) to inform their strategy, engage their boards, connect with their communities, educate elected officials and foster new partnerships that advance shared community and population health goals.

Here are a few practical tips for making the most out of this process:

Leveraging Community Health Research

Spice up the data. Many health systems use outside vendors to gather and analyze community health data, which is then presented via 75+ pages of tables and dry text. Then, most hospitals bury the reports on their website. This is a missed opportunity.

Health systems should identify meaningful numbers and trends for each community they serve to create supporting collateral that brings CHNA findings to life using compelling stories, statistics and graphics. This also provides an excellent opportunity to highlight programs or partnerships a system has developed to address high-priority health issues in the community.

Invite the community into the process. While CHNAs highlight high-priority health issues, addressing those issues requires community input and strategic partnerships—both as the report is being developed and as programs and interventions are designed to address the need. Hospitals and health systems that develop interventions and strategies in a silo – without engaging their target audience and  the community organizations that offer existing infrastructure and subject matter expertise – are likely to see lower return on their community health investment.

Partner with another hospital. Frequently, hospitals just a few blocks from one another develop two separate CHNA reports – even though they might serve the same population.

Instead, they can team up. It may sound strange to partner with a competitor, but community health is a great catalyst for collaboration, which can save each organization money, make for a great story and improve the likelihood of long-term success.   Systems and hospitals that take this approach will need to begin collaboration early to ensure they are on the same schedule and develop a plan to ensure the report is researched, developed and agreed upon by all the parties within the timeline established by IRS guidelines.

Share the results with the community. This might seem obvious, but many hospitals spend months and significant resources developing data-rich CHNAs that they don’t publicize. On the other hand, smart hospitals use CHNAs, or supporting collateral that highlights key findings, as a foundation for engagement.

St. Luke’s Health System in Idaho, for example, does this very well. St. Luke’s facilitates community awareness and involvement through its CHNA process by conducting in-depth interviews with a diverse group of representatives who possess extensive knowledge of community health — including individuals and organizations that serve or represent the interest of medically under-served, low-income and minority populations. These representatives actively participate in selecting, prioritizing and ranking the health needs as well as providing input on how to best address the needs. In developing their CHNAs, St. Luke’s conducts extensive research on four major categories of health needs: health behavior, clinical care, social and economic factors, and physical environment. St. Luke’s also collects local, state and national data on each health need going back 10 years when possible. Having this information allows them to analyze each health need based on its trend, prevalence, severity and magnitude.

Wisely, St. Luke’s also leverages its community board members’ experience and relationships to advance its community health investments. Through this process, the health system makes a meaningful impact that has earned it a positive reputation as a trusted community partner and collaborative leader.

The Community Health Hurdle

Hospitals betting big on community health often discover challenges beyond the scope of their expertise. For example, a community member’s ability to access health services can be severely limited in areas where there is little or no public transit.  In the same way, a patient’s ability to access health coverage in a state that hasn’t expanded Medicaid is a political decision outside the hands of health professionals.

In the face of these challenges, hospitals looking to leverage CHNAs should remember the following:

  • You don’t have to solve every problem. Instead, engage community partners with expertise in the areas your report identifies. If your report finds a high rate of diabetes among community members living in a food desert, you don’t need to open a grocery store. Rather, partner with a local food bank to connect patients with better nutrition options.
  • Your data gives you an authoritative voice. You can’t solve reimbursement issues with CHNAs alone, but you can use your data in your advocacy efforts. Legislators and stakeholders are much more inclined to listen to you when you are armed with your own, community informed, hard-earned research.

In other words, you’re not responsible for solving all of the issues that impact the health of your community. But you are responsible for knowing what they are and how they’re interconnected.  Make the most of your CHNA by utilizing a process that invites community involvement through strategic investment and partnership and by sharing what you learn in an easy-to-understand format.


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