A hospital is a vital part of a community. However, many community hospitals lack the personnel and resources to adequately address a community’s health needs. For Valerie Hayes, MPH CHES, a planning analyst for Community Hospital Corporation, resources like Community Commons’ health needs assessment tool has made all the difference in helping rural hospitals provide better care for their community.
Thanks for joining us Valerie! Could you tell us about Community Hospital Corporation (CHC)?
The CHC mission is to guide, support and enhance the mission of community hospitals and healthcare providers. Our corporate office is located in Plano, TX, and we own, manage, and consult with not-for-profit hospitals across the United States through our three distinct arms – CHC Hospitals (hospital lease or ownership models), CHC Consulting (management services, operational assessments, and consulting), and CHC ContinueCARE (ownership and management of Long Term Acute Care Hospitals). Our services include community health needs assessments, medical staff development plans, market assessments, operational assessments, and more – all helping community hospitals improve and remain viable.
Can you go into more detail on how you assist community hospitals with health needs assessments?
As part of the Affordable Care Act, Section 501(r) of the Internal Revenue Code requires tax-exempt hospital organizations to implement certain policies and procedures in order to receive or maintain their tax-exempt status. Among other requirements, a tax-exempt hospital organization must perform a community health needs assessment or CHNA at least once every three years for each hospital facility that it operates.
Our team uses a six-step process in completing community health needs assessments to comprehensively address the regulations within the Internal Revenue Code. Initially, we establish the parameters and scope of the study area with the hospital by analyzing their inpatient discharge data to see where the majority of their patients are coming from. Once we have a defined study area, we collect and analyze quantitative data such as demographics (population composition by age and ethnicity, population growth by age and ethnicity, and economic factors), health status and behaviors (mortality, chronic conditions, natality, mental health), and access to health care (preventive services, provider rates, barriers to care). We also conduct a qualitative analysis of interview comments from key informants in the community that are identified by the hospital. Key informants may act as community leaders, representatives of minority populations, or persons with special knowledge of public health and related public health organizations.
Sounds like a rigorous process! How do you decide what health needs to focus on?
Upon the completion of our quantitative and qualitative analyses, we document and communicate our results with the hospital’s designated CHNA team through a prioritization meeting. The meeting involves the presentation of the data, identification of significant needs, and the prioritization of such needs through a structured matrix to rank the community health needs based on three characteristics: size and prevalence of the issue, effectiveness of interventions, and the hospital’s capacity to address the need. Once the prioritization process is complete, the hospital leadership team discusses the results and decides which, if not all, of the needs should be addressed in various capacities through the hospital specific implementation plan.
As a final step, we work with the hospital CHNA team to develop their implementation plan based on their prioritized needs, and aim to emphasize all community benefit activities that the hospital is currently doing – as opposed to adding on new, expensive programs. Once the implementation plan is complete, the hospital leadership team takes a summary of the CHNA and implementation plan report to their board for adoption and notation within the meeting minutes before publishing the report on their hospital website.
The development process for community health needs assessments can be very time consuming. Some of the hospitals we work with are in very rural counties that may not have local data easily available. Community Commons allows for our team to quickly and easily access data for our hospitals.
How did you come to use Community Commons for these community health needs assessments?
While I was getting my Master of Public Health (MPH) degree at the University of Illinois at Chicago (UIC), I took a class about community health needs assessments and worked with a group to complete a report for a neighborhood in Chicago. The instructor brought up Community Commons as a useful tool if we were to ever conduct any further reports, and when I first started at CHC, I realized this could be something that would greatly benefit our CHNA process. Data from Community Commons has been a great supplement for our reports. I probably use the tool on a daily basis.
In your experience after running all of these reports, when it gets to the point of priority setting and what people want to address, what are some of those health topics or issues that rural counties seem to all be facing?
Limited access to mental and behavioral health resources and services seems to be an issue across the country; I have yet to see a report that has not identified mental health and behavioral health as a significant need in the community. Other issues that are typically identified include higher prevalence rates of chronic conditions (e.g., diabetes and obesity), a need for health education and an emphasis preventative services, and limited access to primary care and specialty care services. Primary care and specialty care providers can be difficult to recruit to these communities due to the rural nature of the areas.
What would you say is the most rewarding part of your job?
I believe that the most rewarding part of my job is being able to work with the people at CHC who are fully committed to helping rural hospitals succeed. Through our CHNA reports, we are able to help hospitals make informed decisions about how to address the most significant needs that their patient populations are facing, and that helps to guide them in the right direction to increase the health of their community overall.
Learn more about CHC’s Community Health Needs Assessment and Implementation Strategy process, here.