Do Nonprofit Hospitals Evaluate Their Community Benefit Activities?

Area of Science:

• Public Health
• Health Services Research
• Healthcare Management

Background:

• Nonprofit hospitals in the U.S. must conduct Community Health Needs Assessments (CHNAs) every three years.
• These assessments identify community health priorities and require an implementation strategy with impact evaluation.
• The IRS mandate requires evaluation of actions taken to address identified health needs.

Purpose of the Study:

• To assess how nonprofit hospitals respond to the mandate of evaluating their implementation strategies.
• To determine the extent to which hospitals evaluate their community benefit programs.
• To identify the types of evaluation measures used (process vs. outcome indicators).

Main Methods:

• Content analysis of CHNA reports from Minnesota nonprofit hospitals (n=96).
• Reports were reviewed for the period following the finalization of regulations in December 2014.
• Coding focused on the presence of evaluation and the types of indicators (process and outcome) employed.

Main Results:

• 85.3% of reports included narrative evaluations of community benefit programs, indicating widespread compliance.
• All evaluations utilized process indicators (e.g., number of individuals reached).
• Over half (55.2%) incorporated outcome indicators, showing increased use of short- and medium-term health behavior changes over time, particularly in 2017-2020.

Conclusions:

• Minnesota hospitals generally use program evaluation for their community benefit strategies, with varying levels of thoroughness.
• The increasing use of outcome indicators suggests progress, but highlights the need for public health expertise in CHNA evaluations.
• Continued emphasis on outcome evaluation is crucial for demonstrating tangible impact on community health needs.