Community Benefit: Tools and Resources to Get Involved with Non-profit Hospitals to Address Unmet Community Health Needs

The majority of hospitals in the U.S. are non-profit or tax-exempt, and to keep that status these facilities must demonstrate their benefit to the communities they serve. The Community Health Needs Assessment (CHNA), a new mandate under the Affordable Care Act (ACA), provides an opportunity for people to engage their local hospitals, not only in assessing and planning programs to address the health needs of residents but also implementing and evaluating the success of those programs over time. The resources on this page will provide some initial guidance to advocates and community-based organizations as they navigate the community benefit planning process.

Community Benefit -- The Community Health Needs Assessment -- Putting People First --
Other Helpful Resources -- External Resources

Community Benefit: The Basics

Key Community Benefit Terms
This factsheet provides important terms for stakeholders to understand as they work with hospitals to improve community health, as part of the ACA requirements.

Community Benefit and Community Engagement: Basic Facts and Terms
This factsheet provides an overview of federal requirements for non-profit hospitals under the Affordable Care Act, as well as key terms.

Protecting Consumers, Encouraging Community Dialogue: Reform’s New Requirements for Non-profit Hospitals
This document outlines the provisions of the ACA that are focused on non-profit hospitals, and discusses how advocates can engage to make those provisions more effective.

Beyond the ER: What Resources Can a Hospital Provide to Your Community and How You Can Direct the Process
The Affordable Care Act requires non-profit hospitals to follow new rules that will improve access to care and encourage collaboration with community partners. This document provides some questions to help think through how you may use the law to help your community.

Follow the Money: What Hospitals May Not be Telling You

This brief clarifies the distinctions between bad debt and financial assistance programs (aka charity care or free care) by discussing how costs versus charges are reported, as well as shortfalls reported by hospitals, including Medicaid, the Children’s Health Insurance Program (CHIP), and Medicare. 


Assessing Needs: The Community Health Needs Assessment (CHNA)

Reviewing a Hospital’s CHNA: Initial Questions to Consider
These questions will help consumers, advocates and community-based organizations to assess the hospital’s CHNA approaches, including data analysis, community engagement strategies, how they prioritize the issues to be addressed in the Implementation Plan, and support for future research. This document will help communities to plan hospital interactions so they can effectively address the differences between the community’s and the hospital’s priorities.

Digging Deeper: Hospital Finance Sample Questions
This brief factsheet provides a variety of questions that can be used in meetings with hospitals, including how they generate revenue, how they define their community, and how the hospital helps those who can’t afford medical care.

Putting People First: Working with Hospitals to Address Community Needs 
Tools and Resources to Engage Grassroots Participants

Putting People First Curriculum Overview
The Putting People First: Working Together with Hospitals to Improve Community Health curriculum is a set of tools and resources developed to build the capacity of advocates and community-based organizations to engage in the community benefit planning process. Select tools and resources are included on this site. 

Community Benefit/CHNA 101
This sample presentation provides an overview of what is required of non-profit hospitals and how the CHNA fits into non-profit hospital community benefit planning. Also included in the presentation are a discussion and some evaluation questions regarding the community’s role. 

Community Benefit Policy 101
This sample presentation provides readers with an overview of how the Community Catalyst Hospital Accountability Project (HAP) operates and helps them understand community benefit’s key terms and core issues from a policy perspective, using Minnesota, New York and Oregon state community benefit laws as examples.

Data 101
This sample presentation provides an overview of what data is (and isn’t), how and where hospitals compile it and an overview of community assets that should be included as a source of data communities can bring to the table in meeting with their local hospital to discuss their CHNA.

Life Boat Activity
Understanding who is in the room—and who isn’t—is an important component to any workshop relating to health. This activity helps to both understand the demographics and interests of the participants and also provides an opportunity for participants to get to know each other in a fun way. 

What it Takes to Be Healthy
What contributes to being healthy? Is it mostly our genetic code or our zip code? This sample presentation provides an overview of what it means to be healthy, as well as what it takes to be healthy, including a link to a short clip from Unnatural Causes: Is Inequality Making Us Sick, a PBS documentary.

Shine Your Light Activity
What are the barriers to making us healthy? This activity allows participants to metaphorically shine a light  on the barriers to health that they and/or their loved ones experience.

The Powers of Persuasion Activity
As groups prepare to meet and build relationships with their local non-profit hospital, this activity will help them think through their issues and “asks.” Three different potential issues are outlined, but groups can identify their own concerns and follow the instructions to “persuade” hospital decision-makers or other stakeholders in the community.

FAQ: Does the ACA Help Families with Hospital Bills?
This FAQ offers a broad overview of how the ACA and subsequent finalized IRS rules from December 2014 affect hospital billing and collections and Financial Assistance Policies (FAPs). 

Other Helpful Resources and Links

Community Benefit and Anchor Institutions: Linkages and Opportunities

This webinar, organized by Community Catalyst and the Democracy Collaborative, explored how community benefit requirements, especially in the wake of new Affordable Care Act (ACA) regulations governing Community Health Needs Assessments (CHNA), can provide a powerful and effective framework to drive transformative community economic development.  

External Resources

Catholic Health Association Community Benefits website
The community benefits section of the Catholic Health Association website provides numerous publications as well as a “What Counts” section that outlines what counts as community benefit and what does not.

Hilltop Institute Community Benefit Program
Hilltop Institute’s community benefit website provides state law community benefit profiles, as well as numerous issue briefs that can be very helpful in garnering information about what non-profit hospitals are required to do under the ACA.
The CHNA toolkit is a free web-based platform designed to assist hospitals and organizations seeking to better understand the needs and assets of their communities, and to collaborate to make measurable improvements in community health and well-being. 

County Health Rankings
County Health Rankings provides access to county-level health and demographic data that can be helpful for community groups searching for state- and county-level for the years 2010 to present.

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