Current State: Similar but Nonaligned Community Health Improvement Frameworks

This model illustrates the current state of similar but nonaligned community health improvement frameworks of public health organizations and tax-exempt hospitals.

The public health framework for community health improvement is driven by the uncoordinated activities of Public Health Accreditation, Health Resources and Services Administration (HRSA) 330 grant-making, and the assessment and community planning activities of United Way and other community organizations. In this framework, health departments, federally qualified health centers, and other community organizations engage in community health assessment, develop community health improvement plans, and target community investments based on those plans. The final output is improved health outcomes.

The tax-exempt hospital framework for community health improvement is driven by Internal Revenue Service (IRS) Community Health Needs Assessment requirements for tax-exempt hospitals, compliance with IRS community benefit regulations, and state and local activities. In this framework, tax-exempt hospitals conduct community health needs assessments and adopt implementation strategies, create a "plan" for addressing the community's health issues and needs, and execute this "plan" by making investments in hospital community benefit projects. As with the public health framework, the final output is improved health outcomes.