Leveraging Nonprofit Hospital Community Benefit Dollars and Community Health Needs Assessment Requirements for Community Health Innovations

Abstract

Community health assessment is not a new concept. These assessments have been a widely-used tool in public health for decades to bring community health needs to light and to focus community health programs and advocacy (Kretzmann & McKnight, 1993). The Patient Protection and Affordable Care Act of 2010 made them a hot topic in medicine when the legislation revised the conditions for a hospital to maintain its nonprofit status, including a requirement to conduct a community health needs assessment (CHNA) and community health improvement strategy based on those results every three years. This provides a new opportunity to re-examine hospital community benefits with a population health lens, and a new opportunity to address intractable health disparities occurring among the highest need and highest cost communities they serve. However, limited guidance from both the ACA requirements for CHNA and in the current community benefit standards raises questions about whether the implementation of CHNA is ensuring community health needs are being adequately assessed and met as intended (Rubin, Singh, and Young 2015).