Hospitals work to address community needs in compliance with ACA

A provision of the Affordable Care Act (ACA) has hospitals in low-income areas such as Southeast Michigan working to address unmet community health needs, Crain's Detroit Business reports.

Beginning in tax year 2012, the ACA requires not-for-profit providers to join community organizations in assessing health needs in their communities every three years, and IRS regulations require hospitals to develop strategies for meeting these needs. Southeast Michigan providers and community groups address several such needs, including reducing obesity, diabetes, cancer and infant mortality.

Charitable or preventive care has not significantly increased as a result of these reviews, healthcare leaders and local experts told Crain's, but they have helped providers point programs in the direction of highest need.

To conduct the assessments, hospitals formed teams, gathered data on health and chronic disease by demographics they served, conducted community surveys and focus groups, and took suggestions in telephone and in-person interviews. They then developed action plans and submitted them to their boards of trustees.

In 2013, the American Hospital Association (AHA) released a guide to forming meaningful partnerships between hospitals and community organizations, with particular emphasis on small and rural facilities, FierceHealthcare previously reported. Around the same time, the AHA called on Congress to amend the rule to give providers more time and clarify the regulations.

"The process did create some 'aha' moments for some [hospitals] that encouraged them to look at doing some things differently and more effectively," Lori Boyce, director of business tax services with Deloitte Tax LLP in Detroit, told Crain's. "Some hospitals have done a very good job and will accomplish much more for their efforts and dollars [used] than others."

A 2014 review found community benefit programs can assist hospitals in meeting federal requirements, FierceHealthcare previously reported. "The more you can engage the community in the benefit programs you are trying to provide, the greater the likelihood of a positive outcome," said lead author Jessica Burke, Ph.D.

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