Partnerships among Hospitals, Public Agencies, and Community-Based Organizations Can Improve Public Health

WASHINGTON, Dec. 12, 2016

"Health care extends well beyond care settings—into homes, schools, and neighborhoods," said Rebecca Tyrrell, Senior Consultant, Research at Advisory Board. "Hospitals and health systems can improve community health by addressing the nonclinical factors that influence health in their neighborhoods, since partnerships with community organizations can address the upstream causes of poor health."

By 2019, Medicare and Medicaid reforms will affect physician payments based on resource use and total costs of care, prompting hospitals and health systems to focus more strongly than ever on community health as a whole. According to research published in The New England Journal of Medicine, up to 80-90% of health status is attributable to factors other than clinical care. The vast majority of physicians cite socioeconomic conditions such as lower income or education, environmental hazards, and lack of access to healthy food, safe housing, and transportation as leading directly to poorer health outcomes, but only 20% of physicians are confident in their ability to address these problems, according to a study conducted on behalf of the Robert Wood Johnson Foundation.

Hospitals and health systems have struggled to build partnerships that would improve health outcomes and generate significant savings. The new report – Building the Business Case for Community Partnership: Lessons from the BUILD Health Challenge – identifies four critical steps to promote population health management and collaboration across the continuum of care: strongly engage hospital or health system leadership; prioritize initial focus on a subset of initiatives that will be iterated; strengthen partnerships to build on the skillsets, relationships, data, or tools each partner brings; and design seamless screening and referral protocols.

The BUILD initiative, cofounded by Advisory Board to promote partnerships that are Bold, Upstream, Integrated, Local, and Data-Driven, started with grants to 18 communities in 2015. Tyrrell's research of the 18 funded communities reinforced the belief that transforming health outcomes requires a carefully coordinated effort to eliminate silos.

"Partnerships among health systems, public health bodies, and community organizations are the most effective ways to address community health," Tyrrell said. "In many communities, hospitals, local not-for-profit organizations, and health departments are pursuing the same objectives but have not coordinated to share valuable data, information, and resources."

The report found that engaging hospital or health system leadership helps garner the executive buy-in and secure the resources needed for success. Since many health care organizations have multiple initiatives occurring at once, the report suggests that hospital and health system leaders recognize that the process is an iterative one and begin by focusing on a few prioritized services.