Becker's Hospital Review

58 Sign up for the COMPLIMENTARY Becker's Hospital Review CEO Report & CFO Report E-Weeklies at www.BeckersHospitalReview.com or call (800) 417-2035 the issues," Dr. Short says. "The major benefit of Beverly and Addison Gilbert's community benefit program is that we have a really solid grasp of what the health status is of each community that we serve. Thanks to our needs assessment, we know what the key health areas are and what the high-risk populations are." to see the work that we do divert patients, if safe and appropriate, from the ED," Dr. Short says. "But, we recognize that repeat ED visitors need special attention and care, so we try to get to them before they even make it to the ED. Our community benefit program is grounded in lots of good education, early intervention and prevention — all in the community setting." The second phase involves distributing surveys for further data collection. In 2012, Beverly and Addison Gilbert received completed surveys from 1,179 "randomly selected residents in the targeted communities," according to the hospital's community benefit report. Hospitals are able to connect the interviews from phase one to hard data in phase two — and create the right type of health programs in areas that show glaring gaps. Improving for long-term sustainability For example, the hospitals found out that although health insurance coverage was high across their communities (95 percent, thanks to Massachusetts' healthcare reform law), only 40 percent of respondents had dental insurance, and 45 percent of low-income residents had no dental care in the past 12 months. Beverly and Addison Gilbert have since made efforts to ramp up dental care in their communities. In addition, they discovered residents in Gloucester, Mass., use the ED for substance abuse and mental health care at a higher rate than the state average. Consequently, Addison Gilbert implemented a high-risk screening and referral program in its ED. Finally, in the final phase, Beverly and Addison Gilbert disseminate their findings to the community so everyone can be informed of what the health status of the region is — and where those in need can find the right, free care. "It is critical that hospitals engage the community and work closely with key community stakeholders as much as possible," Dr. Short says. "These relationships are key to understanding and tackling the root of the problem and to understanding the nuances that are present in a specific community. Whether it's lack of transportation, ethnic issues or language barriers, community partners can help a hospital overcome these issues and access these high-risk populations." Dr. Short adds that the hospitals' programs hopefully alleviate capacity away from the ED and closer to the community members. "Ideally, we like Subscribe Today! Becker's Hospital Review CEO Report E-Weekly To subscribe to the FREE E-Weekly, visit www.BeckersHospitalReview.com and click on the "E-Weekly" tab or call (800) 417-2035 The community benefit programs at Banner Health and Lahey Health provide obvious value to local residents, but they have become so successful because of their long-term sustainability — a difficult mark to reach considering community benefits programs involve free care and lots of expenses. Executives and team members at both organizations have looked at ways to improve their programs so they don't flame out after a few years. For example, Ms. Christopherson of Banner Health says the system has conducted rigorous strategic planning to make sure the costs of their School-Based Health Centers don't cripple the finances of the organization while still serving the target population. In 2009, the program was operating 15 clinics throughout the region. During 2010, program officials assessed the program to ensure that the clinics were placed in the most strategic places to maximize community benefit. "Some were within a mile of each other," says Ms. Christopherson, "and it just didn't make sense. We kept the ones that served the highest number of kids in the highest areas of need and reworked the hours to keep them accessible to everyone." Through this restructuring, a $700,000 per year program became a $200,000 per year program. "We did not cut down on the number of children seen — just on licensing fees and staff salaries," says Ms. Christopherson. Lahey Health similarly has looked at ways to stay financially solvent. Beverly and Addison Gilbert actively pursue government funding when appropriate. "When we do start a new program, we'll provide the initial funding to get the program off the ground for the first year or so and then will take the pilot results and apply to state and federal grants to continue a line of funding," Dr. Short says. Perhaps most importantly, a hospital has to conduct the right amount of research — both before starting a community benefit program and still while the program is operating — to see how the program continually creates value. For example, if a benefits program becomes too broad or large, will community members forego more appropriate levels of care like physicians' offices? "Depending on the conditions seen in a hospital, the program might encompass conditions that do not show up in the ED, thus reducing benefits to the hospital's financial position," Dr. Helton of Metropolitan State University of Denver says. "Also, patients and insurers are getting pretty savvy in looking for ways to save a dollar. A program could be so attractive that consumers are incentivized to use a free preventive program rather than a more appropriate care setting. There is definitely a diminishing marginal return in such a program." n MORE ONLINE: Want more information on community benefit programs? See the following articles available at www.BeckersHospitalReview.com: n Grow Market Share and Healthier Communities " Through Community Wellness Screenings" (June, 2013) n Caring for the Uninsured: How Free Clinics, Hospitals " Can Partner to Treat a Community's Most Vulnerable" (June, 2013) n 5 Things Hospital Administrators Should Know About " Diabetics and Population Management" (April, 2013)

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