How hospitals can overcome barriers to create healthier neighborhoods

Hospitals can make their neighborhoods and communities healthier by addressing nonmedical factors that contribute to population health, according to a report published in the Journal of the American Medical Association.

In the push for better healthcare outcomes as hospitals transition to value-based care, many advocates have protested that population health largely depends on community factors beyond a hospital's control. But in many cases, hospitals themselves are positioned to help build healthy neighborhoods, writes Stuart M. Butler, Ph.D., senior fellow, economic studies at the Brookings Institution in the District of Columbia. Many hospitals have longstanding collaborations with community resources, and post-Affordable Care Act, nonprofit hospitals are required to regularly assess their communities' health needs and how they plan to tackle them.

Despite these efforts, according to the piece, hospitals seeking to actively intervene for better community health face several barriers. For example, information tends to be segregated and difficult to share due to lack of standardized data systems among hospitals, government agencies and community organizations. In addition, much of the data are also subject to privacy regulations.

Providers also face the "wrong pockets" disincentive, according to Butler: community investment comes out of a hospital's pocket without any direct return, and the prospect of a healthier patient population using fewer healthcare services compounds the loss.

"Hospitals are usually seen as the last resort in their communities--the place you go when other things fail. Yet they have enormous potential to be partners in improving the general health of the community," Butler writes. "Unfortunately, there are obstacles to them playing this role. These need to be fixed."

To fix these problems, he suggests the healthcare industry take key steps:

  • Tighten and standardize the way social and economic benefits of hospital efforts are measured
  • Ease the process of information-sharing to help government agencies, hospitals and community institutions coordinate
  • Fix the "wrong pocket" problem by adjusting government budgets and payment systems toward the goal of a joint return on investment when community benefit is achieved
  • Explore new forms of investment capital to finance community health improvements that don't generate hospital revenue

To learn more:
- read the report

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