Confronted with revenue shortfalls, the COVID-19 pandemic, and health disparities, states are tapping all available resources to address urgent health needs and plan for long-term recovery. Accessing new Coronavirus Aid Relief and Economic Security (CARES) Act resources, pursuing flexibility with current funds, and leveraging hospitals’ community benefit tax exemptions are strategies states are employing to meet their residents’ health needs, particularly those affected by long-term structural inequities.
A review of 10 states’ health plans contained in this analysis shows that states continue to prioritize long-standing health issues, such as improving access to health care and reducing chronic disease, cancer, and infant mortality. States are also increasingly focused on the upstream factors that impact health, including social determinants of health (housing, economic security, food access, adversity, trauma, toxic stress and racism.)
States can use these tools to increase hospital’s community benefit investment accountability by tying community benefit requirements to state-level health goals. For example:
- Massachusetts has aligned community benefit requirements with state health priorities by tying its Department of Public Health’s determination of need process to specific standards for community engagement and social determinant of health investing.
- New York requires that hospital community health improvement plans specifically address goals contained in its State Health Improvement Plan, Prevention Agenda 2019-2024. New York also requires hospitals to report their community benefit spending as it relates to its Prevention Agenda’s goals.
States can also use these resources to identify and assess measures of progress for community benefit investments and activities. Connecticut has performed a community and state crosswalk comparison analysis of its State Health Improvement Plan and hospital community benefit plans. It is creating a dashboard of measures to track the impact of hospital community benefit investment on State Health Improvement Plan goals.
In this time of high needs and scarce resources, it is critical for state governments to operate as efficiently and effectively as possible and tap into all available resources. This new NASHP chart is designed to help states identify, measure, and advance state health goals by focusing the local efforts of nonprofit hospitals to reflect state priorities.