Online Program

Successes and Challenges in Community Health Improvement: Perspectives from Early Collaborations

Wednesday, November 4, 2015 :

Monica Valdes Lupi, JD, MPH, Health Systems Transformation, ASTHO, Arlington, VA
Megan Miller, MSW, Association of State and Territorial Health Officials (ASTHO), Arlington, VA
Kristen Wan, MS, PAPHS, Association of State and Territorial Health Officials, Arlington, VA
Background: Under the Affordable Care Act (ACA), the IRS requires tax-exempt hospitals to implement community health needs assessments (CHNAs) and strategies. Although governmental public health, hospitals, and other community organizations have collaborated for years, these assessments and strategies create an important opportunity to improve the health of communities.

Methods: ASTHO conducted interviews with representatives from health systems, non-profits, community health organizations, and public health officials in Massachusetts, Maryland, and North Carolina to gather their perspectives on CHNA implementation. The purpose of the interviews was to capture a systems-level view of the challenges and opportunities which CHNAs and population health improvement present. 

Results: While various challenges continue to exist across states, strategies for managing these and other emerging challenges have been realized since the implementation of the ACA. In addition, new opportunities to align and evaluate existing state practices aimed at promoting effective and efficient population health improvement have emerged. For example, hospitals and public health are working together to better coordinate the regulatory requirements for federal and state mandates related to community health processes in order to reduce duplication of assessment in a given community.

Conclusions:  The IRS requirement to implement CHNAs and strategies provides an important opportunity for tax-exempt hospitals to work with state public health and other stakeholders to improve overall population health through increased cross-sectoral collaboration. In an era of transformative change, these partnerships are important and worth pursuing as they have the potential to yield new opportunities for innovative and sustainable strategies to improve community health.

Learning Areas:

Assessment of individual and community needs for health education
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Describe how states who have implemented Community Health Needs Assessments (CHNAs) have created opportunities between hospitals, public health, and populations at large to improve community health.

Keyword(s): Community Health Assessment, Affordable Care Act

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I lead a team at ASTHO which includes: Medicaid Partnerships with Public Health; Public Health Integration; Public Health Informatics; State Health Policy; and Health Equity. I previously served as the Massachusetts Deputy Commissioner and chief of staff with responsibility for leading the day-to-day operations of the State Health Department. I also previously worked at the Boston Public Health Commission as a senior program manager and served my final years as the Chief of Staff.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.