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Community Benefit Assessment and Planning

Assessing community health needs and developing and implementing plans to address priority health needs is essential to effective community benefit programs. These activities are part of the long tradition of not-for-profit health care organizations’ efforts to improve the health of their communities.

Additionally, the Patient Protection and Affordable Care Act (ACA), enacted March 23, 2010 and the IRC Section 501(r)(3) requires tax-exempt, non-governmental hospitals to conduct a community health needs assessment (CHNA) and develop and adopt a CHNA report and an Implementation Strategy (IS), which identify and describe plans to address identified significant community health needs, at least once every 3 years.

Conducting a Community Health Needs Assessment

Community Health Needs Assessment (CHNA) is a systematic process involving the community to prioritize, plan and act on community health needs. This process results in a written report.

The IRC Section 501(r)(3) state that the written report must be adopted by the governing board of each hospital facility, made widely available to the public, and include:

  • Definition of community served,
  • Description of the process and methods used to assess the health needs of the community,
  • How the hospital solicited and took into account input from the community, including a public health agency, on identifying and prioritizing significant community health needs,
  • Description of significant community health needs and prioritization,
  • Description of resources potentially available to address the identified needs, and
  • Evaluation of impact of any actions taken since prior CHNA.
CHNA Resources

Developing an Implementation Strategy

Implementation Strategy (IS) is the hospital's written plan for addressing community health needs, including the priority health needs identified in the community health needs assessment. While the term "implementation strategy" was introduced by the Affordable Care Act provisions, other terms that are commonly used are community health improvement plan (CHIP) and action plan.

The IRC  Section 501(r)(3) states that the IS written report must be adopted by the governing body of the hospital facility and either attached to Form 990, Schedule H or posted online. The written IS describes,

  • What actions the hospital plans to take to meet significant health needs identified in its CHNA,
  • The anticipated impact of these actions,
  • The programs and resources the hospital plans to commit to address those health needs, and
  • Any planned collaboration between the hospital facility and other facilities or organizations.
  • For each significant health need identified in its CHNA report that the hospital does not intend to meet, the IS needs to explain why the hospital does not intend to meet that heath need.
Implementation Strategy Resources

Program Planning and Implementation

Once you have developed your implementation strategy, it may be necessary to develop and implement programs for the strategies identified. Program plans describe what you plan to do and the intended results. Many organizations use logic models and SMART goals when developing and monitoring programs. It is important when planning programs to include how you will monitor and evaluate the program implementation outputs, outcomes, and impact.
Program Planning and Implementation Resources

Recommended Resources

Assessing and Addressing Community Health Needs

This resources offers practical advice on how hospitals can work with community and public health partners to assess community health needs and develop effective strategies for improving health in our communities.

Assessing And Addressing Community Health Needs: A Summary Of New Requirements and Recommended Practices

A concise overview of federal requirements for tax-exempt hospitals to conduct community health needs assessments and adopt implementation strategies to address identified needs. This resource aligns with IRS final rules.

A Guide for Planning and Reporting Community Benefit

CHA's A Guide for Planning and Reporting Community Benefit provides a comprehensive framework for health care organizations desiring to develop a strategic approach to planning, delivering and reporting on community benefit programs.