MHA, Partners Help Hospitals Drive Health Improvement Through CHNAs

Hospitals are essential partners in creating healthier communities in addition to caring for patients and treating illnesses.

Across Missouri and the nation, hospitals use community health needs assessments as an integral tool to identify local challenges, engage community partners and develop programs that improve health — both inside and beyond the hospital’s walls.

CHNAs identify care opportunities

To be treated as a nonprofit, hospitals must meet additional requirements including conducting a CHNA every three years and adopting an implementation strategy to meet community health needs identified in the assessment.

A CHNA is more than a regulatory requirement, according to Stephen Njenga, director of quality measurement and population health improvement at the Missouri Hospital Association, as these assessments seek to identify care gaps and opportunities that exist within each community, shaping the health and well-being of people.

“Every community is different because those in the community have varying levels of resources,” Njenga said.

CHNAs can be “eye opening” for hospital and health system leaders as they learn about factors outside of their hospital that can impact or interfere with their patients’ health, added Njenga, who works with Missouri hospitals as they develop their CHNAs.

The role of data in CHNAs

CHNAs are driven by both robust data and community engagement. With support from the Hospital Industry Data Institute, MHA’s data company, Missouri hospitals have access to cutting-edge tools that help identify strategies they can implement to close care gaps.

Two of those platforms include the exploreMOhealth.org website, HIDI’s flagship CHNA platform, and health data on MissouriHealthMatters.com , where hospitals can identify differences in the prevalence of diseases among different population segments, said Mat Reidhead, MHA’s vice president of research and analytics.

MHA and HIDI also offer hospital-specific Determinants of Health Dashboards, “where you can drill down to actual patients who experienced X, Y or Z — both in your health care setting and across any hospital setting in the state,” Reidhead said.

This data allow hospitals to determine what health needs and nonmedical factors are most acute in their communities for various segments of their patient population.

Connecting the data to the people who live, work, play and learn in the communities served by hospitals can provide important context, Njenga added.

Community forums with people who are representative of the hospital’s service area are often used in the CHNA process, ensuring different voices are heard, Njenga said. These individuals can offer insight on whether the presented data reflects real issues. Their firsthand knowledge of local challenges, demographics and available resources is essential.

From assessment to action

One example of how data provided by HIDI and a CHNA came together to benefit Missourians occurred at Barnes-Jewish Hospital in St. Louis. The hospital’s emergency department was seeing high rates of usage among patients experiencing severe behavioral health conditions that were exacerbated by housing instability, Reidhead said.

In response, Barnes-Jewish Hospital launched the Hospital to Housing program as a behavioral health priority area in the hospital’s CHNA. When the hospital partnered with St. Patrick Center and Living in Victory Recovery Sober Living to provide transitional housing to these individuals, emergency department utilization fell by half, resulting in a significant drop in overall health care spending.

The program illustrates how addressing nonmedical needs, like housing, can improve health outcomes, reduce hospital utilization, and according to a formal evaluation conducted by MHA, induce significant savings across the health care system.

While the robust return on investment created by the H2H program is critical to demonstrate when engaging payers and policy makers, the crux of the program is in its transformative effects on human lives, and that’s a beautiful thing that’s hard to quantify, Reidhead said.

At smaller hospitals in Missouri, Njenga has seen similar needs, such as food insecurity, being addressed through CHNAs. For instance, when one hospital identified patients who needed help with meals, staff responded by immediately providing food bags to meet patients’ short-term needs. Then, patients were connected with local food pantries and community resources to ensure they received ongoing access to food.

CHNA resources for hospitals

From CHNA templates to guidance and implementation strategies, MHA’s website offers many resources to assist hospitals with these assessments.

The webpage also includes 10 priority health issues commonly found in CHNAs from Missouri hospitals. They include mental health, substance use, obesity, access to care, diabetes, chronic conditions, affordable health care, the COVID-19 pandemic, heart disease and the unhoused.

In addition, Quality Works, a subsidiary of MHA, can provide hospitals with customized services for CHNAs, including primary and secondary data collection and analysis, facilitation of community input, survey design, writing the assessment and development of an implementation plan.

To learn more, listen to this episode of MHA’s PolicyHuddle podcast as Njenga and Reidhead discuss the tools and processes of successful CHNAs.