| Notes |
Presence Health, a member of Ascension, the United States’ largest non-profit health system, had a problem. In its 2013 Community Health Needs Assessment, Presence Health found that 16.7% of residents in four of the Chicago-area neighborhoods it serves had been diagnosed with asthma. That figure was higher than the city, state, and national averages.
Beyond the individual health consequences, this high prevalence of asthma presented a massive cost burden to the community and state. In 2018, the Center for Disease Control (CDC) estimated that asthma costs the U.S. economy $80 billion a year in medical care, missed days of work and school, and death. Presence Health understood that to truly make a difference, it would need to take upstream action to prevent disease in the first place. Fully motivated, they had to figure out what to do, and how to pay for it.
Nonprofit Hospitals and Community Health
A key policy lever came in the form of the Affordable Care Act, which requires nonprofit hospitals to coordinate with public health officials and community members every three years to create a needs assessment and implementation strategy to diagnose and address local health problems. Community benefit funds are then directed to confront these health disparities.
Historically, with little incentive to innovate, community benefit programs have been reactive, fulfilling basic requirements but failing to fundamentally and meaningfully address broader community health challenges. Billions of dollars were traditionally tied up in uncompensated care and bad debt support. Now, the Affordable Care Act encourages community benefit funds to allocate capital towards local health priorities. With incentives and regulatory statutes currently aligned, many are now taking more proactive steps to finance prevention.
Presence Health & The Nationwide Innovators
Presence Health saw the opportunity to leverage community benefit funds to tackle the root causes of asthma—largely, the environmental triggers found in many urban and low-income homes. In partnership with the Green & Healthy Homes Initiative (GHHI) and Elevate Energy, Presence Health is using community benefit dollars to go into homes and improve air quality through the removal of mold, pests, dust mites, and other common environmental factors.
And Presence Health is not alone. Throughout the country, nonprofit hospitals are partnering with local governments, civil society, schools, and community-based organizations to effectively deploy their community benefit funds toward unique and far reaching projects that address the social determinants of health.
In Ohio, the City of Cleveland and Cuyahoga County are assessing how to use community benefit financing to reduce the number of lead poisoning incidences among children in lower-income urban areas.
In the 7 states it serves, the nation’s third largest hospital system—Providence St. Joseph Health (PSJH)—invested $1.6 billion in community benefit programs in 2017 to address factors such as education, housing, nutrition, and transportation. And
across the U.S., nonprofit hospitals are beginning to see community benefit programs as more than a requirement. They are using it to respond to deep-rooted health inequities and transform the communities they serve. |