• Nonprofit hospitals and community health needs assessments

      Stephens, Beth (Georgia Public Health Association, 2015)
      Background: The Patient Protection and Affordable Care Act of 2010 requires all hospitals filing as 501(c)(3) nonprofit organizations to conduct a Community Health Needs Assessment (CHNA) every three years. Many Georgia hospitals published their first CHNAs in 2012 and 2013. The goals of this research and policy project were to assess compliance with the new CHNA requirements for nonprofit hospitals, provide recommendations to hospital administrators and policymakers, and encourage hospitals to engage in meaningful ways with community-based organizations and local public health departments in the next round of CHNAs. Methods: With funding from the Healthcare Georgia Foundation, Georgia Watch reviewed the initial CHNAs of 38 nonprofit hospital facilities in Georgia. Georgia Watch developed an evaluation tool to assess hospital compliance with five major components of the new CHNA requirements: 1) defining community; 2) collecting secondary data on community health; 3) gathering community input and primary data; 4) prioritizing community health needs; and 5) implementing strategies to address identified community health needs. To gain a deeper understanding of hospital processes, Georgia Watch supplemented document review with hospital leadership interviews and a survey of community input providers. This research was intended to inform, assist, and encourage citizens, community health stakeholders, public health departments, and hospital administrators. At the end of the session, audience members were better equipped to evaluate the adequacy of nonprofit hospital CHNAs within their own communities and encourage local hospitals to develop effective community benefit programs. Results: Georgia Watch found that hospitals are still learning how to navigate the CHNA process and that improvements can be made during the next round of CHNAs. Conclusions: Georgia Watch’s research provides insight on how hospitals can best engage their communities, prioritize local health concerns, initiate valuable partnerships, and develop meaningful, evidence-based strategies to address community health needs.Methods: With funding from the Healthcare Georgia Foundation, Georgia Watch reviewed the initial CHNAs of 38 nonprofit hospital facilities in Georgia. Georgia Watch developed an evaluation tool to assess hospital compliance with five major components of the new CHNA requirements: 1) defining community; 2) collecting secondary data on community health; 3) gathering community input and primary data; 4) prioritizing community health needs; and 5) implementing strategies to address identified community health needs. To gain a deeper understanding of hospital processes, Georgia Watch supplemented document review with hospital leadership interviews and a survey of community input providers. This research was intended to inform, assist, and encourage citizens, community health stakeholders, public health departments, and hospital administrators. At the end of the session, audience members were better equipped to evaluate the adequacy of nonprofit hospital CHNAs within their own communities and encourage local hospitals to develop effective community benefit programs. Results: Georgia Watch found that hospitals are still learning how to navigate the CHNA process and that improvements can be made during the next round of CHNAs.
    • Patient-centered outcomes for GoStrong: A self-management diabetes program in Savannah, GA

      Yang, Frances; Roberts, Lizzann; Davis, Bionca; Christianson, Angela (Georgia Public Health Association, 2015)
      Background: To advance the goal of health improvement for diverse populations with diabetes, a patient-centered approach is foundational. Methods: Innovative methods were used to initiate and advance an approach to diabetes engagement and self-management. We began with a strategy to understand how patients with diabetes view and interact with the disease via the medical community and moved to program development through patient-centered design and to the development of strategic partnerships and continuous learning from patients, stakeholders, and academic research partners. Results: The mean age of the participants in the GoStrong™ program (n=106) was 51 ±9.2 (SD) years. There were significant differences in the HbA1c levels over time compared to the Control group (n=100). The mean HbA1c level from baseline to 36 months decreased from 7.49% to 6.89%, with the largest decline (to 6.28%, p<0.01) at 12 months. The mean HbA1c level for the control group increased from 8.38% to 8.49% from baseline to 36 months, with the largest increase (to 8.89%, p<0.01) at 18 months. There were significant differences for total medical costs at 12 months prior to and 12 months after starting the GoStrong program, a difference in total prescription drug costs at 12 months, and differences within the total group in number of emergency room (ER) visits. Claims information showed that GoStrong produced significantly lower total medical costs and ER visits. There was also an increase in total prescription drug costs that may be due to better medication adherence. Conclusions: For diabetics, the GoStrong program results in reduced HbA1c levels, reduced costs, and reduced ER visits.