Hospital Involvement in Screening for and Addressing Patients' Health-Related Social Needs.

The number of hospitals screening patients for health-related social needs (HRSNs) has increased substantially in recent years, yet little is known about the extent to which hospitals invest in programs or strategies aimed at addressing identified needs. Using data from the 2022 American Hospital Association (AHA) Annual Survey for 2,468 non-federal general medical and surgical hospitals, this study explored screening rates and related interventions for eight HRSNs: housing, food insecurity, utilities, interpersonal violence, transportation, employment or income, education, and social isolation. Sample hospitals screened for an average of 6.

Perspectives on Public Health Department Accreditation: Lessons Learned From Ohio's Accreditation Mandate.

Context: Ohio is the only state that requires local health departments (LHDs) to be accredited by the Public Health Accreditation Board (PHAB). As of May 2024, 80% of Ohio's 111 LHDs achieved accreditation, making Ohio the state with the highest proportion of accredited LHDs in the country.

Objectives: This study examined the experience of public health accreditation in Ohio including the perceived value of PHAB accreditation for LHDs.

Ohio Presents Opportunities For Understanding Hospital Alignment With Public Health Agencies On Community Health Assessments.

Multisector collaboration is critical for improving population health. Improving alignment between nonprofit hospitals and local health departments is one promising approach to achieving health improvement, and a number of states are exploring policies to facilitate such collaboration. Using public documents, we evaluated the alignment between Ohio nonprofit hospitals and local health departments in the community health needs they identify and those they prioritize.

New insights about community benefit evaluation: Using the Community Health Implementation Evaluation Framework to assess what hospitals are measuring.

Background: Nonprofit hospitals are required to conduct community health needs assessments (CHNA) every 3 years and develop corresponding implementation plans. Implemented strategies must address the identified community needs and be evaluated for impact.

Purpose: Using the Community Health Implementation Evaluation Framework (CHIEF), we assessed whether and how nonprofit hospitals are evaluating the impact of their CHNA-informed community benefit initiatives.

A national overview of nonprofit hospital community benefit programs to address the social determinants of health.

Decades of research have solidified the crucial role that social determinants of health (SDOH) play in shaping health outcomes, yet strategies to address these upstream factors remain elusive. The aim of this study was to understand the extent to which US nonprofit hospitals invest in SDOH at either the community or individual patient level and to provide examples of programs in each area. We analyzed data from a national dataset of 613 hospital community health needs assessments and corresponding implementation strategies.

Estimating the Cost of the COVID-19 Response for Local Health Departments: Evidence From Ohio.

This study assessed the staffing allocations and associated costs incurred by Ohio local health departments (LHDs) in response to the challenges posed by the COVID-19 pandemic. Data were extracted from the annual financial reports of Ohio LHDs for 2020 and 2021, encompassing a sample of 38 LHDs in 2020 and 60 LHDs in 2021. Descriptive analysis showed that Ohio LHDs committed substantial resources to responding to the COVID-19 pandemic.

Inclusion of Health Equity Initiatives in Hospitals' Strategic Plans.

Objective: This study examined the health equity initiatives included in US hospitals' strategic plans.

Methods: Using data from the American Hospital Association (AHA) 2021 Annual Survey, the study described the types of health equity initiatives that US hospitals included in their strategic plans. The analysis focused on the following seven initiatives: (1) equitable and inclusive organizational policies; (2) systematic and shared accountability for health equity; (3) diverse representation in hospital and health care system leadership; (4) diverse representation in hospital and health care system governance; (5) community engagement; (6) collection and use of segmented data to drive action; and (7) culturally appropriate patient care.

Differential impact of hospital and community factors on breadth and depth of hospital population health partnerships.

Objective: The aim was to identify hospital and county characteristics associated with variation in breadth and depth of hospital partnerships with a broad range of organizations to improve population health.

Data Sources: The American Hospital Association Annual Survey provided data on hospital partnerships to improve population health for the years 2017-2019.

Design: The study adopts the dimensional publicness theory and social capital framework to examine hospital and county characteristics that facilitate hospital population health partnerships.

Evaluation of Community Benefit Activities Among Nonprofit Hospitals, 2018-2021.

Objective: This study examined approaches that nonprofit hospitals use to evaluate community benefit activities in the Community Health Needs Assessment/Implementation Plan (CHNA/IP) process.

Design: Content analysis of CHNAs/IPs completed between 2018 and 2021 from a 20% stratified random sample (n = 503) of US nonprofit hospitals.

Main Outcome Measures: A coding sheet was used to record details about the evaluation content reported by hospitals in their CHNAs/IPs.

Hospital Community Benefit Reporting: How Group Reporting Practices Limit Accountability.

Objective: To identify the prevalence of group reporting of hospital community benefit efforts to the Internal Revenue Service (IRS) and understand hospital and community characteristics associated with this practice.

Design: The study was based on data collected from publicly available community benefit reports from 2010 to 2019, as well as secondary data from the 2020 American Hospital Association (AHA) Annual Survey. The sample was drawn from the entire nonprofit US hospital population reporting community benefit activities.

Individualized Out-of-Pocket Price Estimators for "Shoppable" Surgical Procedures: A Nationwide Cross-Sectional Study of US Hospitals.

Unlabelled: To estimate the nationwide prevalence of individualized out-of-pocket (OOP) price estimators at US hospitals, characterize patterns of inclusion of 14 specified "shoppable" surgical procedures, and determine hospital-level characteristics associated with estimators that include surgical procedures.

Background: Price transparency for shoppable surgical services is a key requirement of several recent federal policies, yet the extent to which hospitals provide online OOP price estimators remains unknown.

Methods: We reviewed a stratified random sample of 485 U.

Trends in the Provision of Community-Building Activities by Nonprofit Hospitals, 2010-2019.

As part of their annual tax report, nonprofit hospitals are asked to report their community-building activities (CBAs); yet, little is known to date about hospitals' spending on such activities. CBAs are activities that improve community health by addressing the upstream factors and social determinants that impact health. Using data from Internal Revenue Service Form 990 Schedule H, this study used descriptive statistics to examine trends in the provision of CBAs by nonprofit hospitals between 2010 and 2019.

A Uniform Chart of Accounts: Strengthening Public Health Practice and Research Through Standardized Financial Data.

Context: The COVID-19 pandemic made the long-standing need for a national uniform financial reporting standard for governmental public health agencies clear, as little information was available to quantify state and local public health agencies' financial needs during the pandemic response. Such a uniform system would also inform resource allocation to underresourced communities and for specific services, while filling other gaps in practice, research, and policy making. This article describes lessons learned and recommendations for ensuring broad adoption of a national Uniform Chart of Accounts (UCOA) for public health departments.

Overview of the Most Commonly Identified Public Health Needs and Strategies in a Nationally Representative Sample of Nonprofit Hospitals.

Nonprofit hospitals have been required to conduct Community Health Needs Assessments and develop implementation strategies for almost a decade, yet little is known about this process on the national level. Using a nationally representative dataset of 2019 to 2021 nonprofit hospital community benefit reports, we assessed patterns in hospital identification of community health needs and investments in corresponding programs. The five most common needs identified by hospitals were mental health (identified by 87% of hospitals), substance use (76%), access (73%), social determinants of health (69%), and chronic disease (67%).

Staffing Up and Sustaining the Public Health Workforce.

Objectives: Estimate the number of full-time equivalents (FTEs) needed to fully implement Foundational Public Health Services (FPHS) at the state and local levels in the United States.

Methods: Current and full implementation cost estimation data from 168 local health departments (LHDs), as well as data from the Association of State and Territorial Health Officials and the National Association of County and City Health Officials, were utilized to estimate current and "full implementation" staffing modes to estimate the workforce gap.

Results: The US state and local governmental public health workforce needs at least 80 000 additional FTEs to deliver core FPHS in a post-COVID-19 landscape.

Equity as a Guiding Theme in Hospitals' Community Health Needs Assessments.

Introduction: This study explores the relationship between nonprofit hospitals' use of equity as a guiding theme in the development of their community health needs assessments and the level of alignment between the health needs identified in the community health needs assessment and those addressed in hospitals' implementation strategy.

Methods: Using data from a nationally representative data set of 485 nonprofit hospital community health needs assessments for the years 2018-2021, this study employed a multivariate logistic regression model to examine the association between hospitals' use of equity as a guiding theme in the community health needs assessment and binary indicators of alignment for 6 common community health needs: access to care, chronic illness, obesity, mental health, substance use, and social determinants of health.

Results: Hospitals using equity as a guiding theme in their community health needs assessment reported significantly greater alignment for 3 needs: access to care (OR=3.

Exploring the Role of Community Social Capital in Not-for-profit Hospitals' Decision to Engage Community Partners in the Community Health Needs Assessment Process.

Not-for-profit hospitals (NFPs) frequently partner with community organizations to conduct internal revenue service-mandated community health needs assessment (CHNA), yet little is known about the number of partnerships that hospitals enter into for this purpose. This article uses "American Hospital Associations' 2020 Annual Survey" data to examine hospital-community partnerships around the CHNA and the role that community social capital defined as, "the networks that cross various professional, political and social boundaries to reflect community level trust needed to pursue shared objectives" plays in hospitals' choices to partner with community organizations for the CHNA. After controlling for a set of hospital, community, and state characteristics, we found that hospitals present in communities with higher social capital were likely to partner with more community organizations to conduct CHNA.

The Role of Local Health Departments in Strengthening the Alignment Between Nonprofit Hospitals' Community Health Needs Assessments and Their Implementation Strategies.

Nonprofit hospitals frequently partner with their local health department on developing community health needs assessments (CHNAs); yet, little is known about the role that such partnerships play in strengthening the alignment between needs identified in hospitals' assessments and the strategies adopted by hospitals to address identified needs. Using data for 486 hospitals from the third round of CHNAs (spanning the years 2018-2021), this study showed strong alignment between the health needs identified in the CHNAs and those addressed in hospitals' implementation strategies, independent of collaboration with the local health department. One noteworthy exception to this finding was that hospital-public health collaboration remained important for improved alignment of needs related to substance use.

Exploring the Relationship Between Local Governmental Spending on the Social Determinants of Health and Health Care Costs of Privately Insured Adults.

Greater investment in the social determinants of health (SDOH) is positively associated with improved health outcomes of both individuals and their communities, which in turn may help to bend the health care cost curve and reduce health care spending. The purpose of this study was to examine the relationship between local governments' spending on the SDOH and the health care costs of privately insured nonelderly adults. Annual spending by local governments on the SDOH for the years 2007-2017 was obtained from the Census of Governments.

Funding Community Health Activities: An Experiment Comparing Health Foundation's Priorities to Those of Public Health Agencies, Hospitals, and Nonprofit Organizations.

Context: Health foundations provide significant financial resources for community health. Foundation priorities, therefore, can play a key role in setting community agenda, but little is known about the criteria foundations use to prioritize projects.

Objective: To understand the priorities that guide decision makers in health foundations and compare those priorities with what is known about nonprofit hospitals, public health, and community-based nonprofits.

Medicaid Expansion and Not-For-Profit Hospitals' Financial Status: National and State-Level Estimates Using IRS and CMS Data, 2011-2016.

Several studies have shown that Medicaid expansion has improved hospital financial performance. All of these studies have either used data from the Internal Revenue Service (IRS) or the Centers for Medicare and Medicaid Services (CMS), and none of them has examined the state-level impact of expansion on hospital finances. Using data for not-for-profit hospitals from both IRS and CMS for 2011-2016, we described the difference in costs related to uncompensated care and Medicaid shortfalls.

Funding Public Health: Achievements and Challenges in Public Health Financing Since the Institute of Medicine's 2012 Report.

Objective: The purpose of this study was to review changes in public health finance since the 2012 Institute of Medicine (IOM) report "For the Public's Health: Investing in a Healthier Future."

Design: Qualitative study involving key informant interviews.

Setting And Participants: Purposive sample of US public health practitioners, leaders, and academics expected to be knowledgeable about the report recommendations, public health practice, and changes in public health finance since the report.

The impact of Maryland's payment reforms on hospital community benefit efforts.

Background: In 2014, Maryland established a global budget policy for all hospitals in the state. Under this policy, hospitals are incentivized to not only provide clinical care services to individual patients but also address the health needs of their broader patient population through prevention efforts and investment in the upstream social and economic factors that determine health.

Purpose: To better understand the incentives created for hospitals under this policy, our study assessed whether the implementation of global budgets changed the levels and patterns of Maryland hospitals' investments in community benefits.

Evidence that collaborative action between local health departments and nonprofit hospitals helps foster healthy behaviors in communities: a multilevel study.

Background: The Patient Protection and Affordable Care Act of 2010 (ACA) encouraged nonprofit hospitals to collaborate with local public health experts in the conduct of community health needs assessments (CHNAs) for the larger goal of improving community health. Yet, little is known about whether collaborations between local health departments and hospitals may be beneficial to community health. In this study, we investigated whether individuals residing in communities with stronger collaboration between nonprofit hospitals and local public health departments (LHDs) reported healthier behaviors.