With the passage of the Patient Protection and Affordable Care Act (ACA), all not-for-profit, nongovernmental hospitals must complete a 3-year community health needs assessment (CHNA) by the end of FY 2013. The cost of noncompliance is high – hospitals face a $50,000 excise tax for each year their CHNA remains outstanding and could even lose their not-for-profit status.
It may be a regulatory mandate, but the CHNA also gives hospitals an opportunity to pursue their mission and expand their presence, identifying the needs of the community and how they intersect with the organization’s strategic plan. Savvy senior leadership teams will use the CHNA process to focus on population-based healthcare efforts, which are vital in the post-ACA healthcare market.
Central to the premise of the ACA is the notion that “health” goes beyond the traditional provision of care in a hospital setting. In this new context, health encompasses all medical, psychological, and social needs, including such issues as lack of fresh food choices, child care shortages, and limited psychiatric resources. The intent of the CHNA mandate is to compel hospitals to take a collaborative approach to addressing these needs in their communities. Based on the findings of the CHNA, the hospitals must create and deploy an implementation plan, referred to as a community health improvement plan (CHIP), to address each identified need.
Traditionally, hospitals have conducted the strategic planning process as a predominantly hospital-focused exercise. As the industry shifts toward a focus on preventive care, community-based health efforts, and value-based provision of care, collaboration across the spectrum of healthcare and social support providers will prove crucial to the future health of the communities and livelihood of the hospitals and health systems.
By incorporating the CHNA process into the larger strategic planning process, hospitals can identify innovative approaches to pursuing mission-driven activities and services through relationships with other community organizations. The graphic below demonstrates how hospitals can evaluate the intersection of strategy and community benefit.
Those initiatives that are both of high community benefit and high strategic importance should be prioritized for the hospital to pursue; in contrast, those that are of high community benefit but low strategic relevance to the hospital may be better addressed by another organization in the community.
As your organization prepares to launch the CHNA process, consider the following questions:
- Does the hospital’s strategic plan adequately address the industry’s move toward population health management and community-focused health initiatives?
- How does the CHNA and its related improvement plan intersect with the hospital’s strategic plan, and what variances are revealed?
- What are the gaps identified by the CHNA that need to be filled by community organizations, and how can the hospital and its employees support these parties?
- How will strategically acting upon the CHNA enhance the hospital’s standing in the community? How will it advance the mission and vision?
Our next post will detail the CHNA and CHIP processes.
If you’d like to learn how to maximize your investment in CHNA now, read the Executive Briefing available on our Web site.