title: The impact of the Affordable Care Act on hospital-led community health evaluation in the U.S. Appalachian Ohio region.
abstract: In recent years, policy developments in the United States have dramatically changed how nonprofit hospitals interact with surrounding communities. However, despite the importance of these changes encoded in Internal Revenue Service regulations, little is known about how these requirements have affected how nonprofit hospitals are approaching community health evaluation. We present qualitative findings from interviews with hospital employees and consultants overseeing preliminary rounds of community health needs assessments, as required by the Affordable Care Act. The sample comes from the Appalachian region of Ohio, an area targeted because of significant health challenges. Our findings suggest that the Affordable Care Act has led hospitals to formalize their processes, focus on developing an evidence base, cultivate local partnerships, and reflect on the role of the hospital in public health.
authors.affiliation: Heritage College of Osteopathic Medicine, Department of Social Medicine, Ohio University, Athens, OH, USA.
authors.forename: Berkeley
authors.identifier: http://orcid.org/0000-0003-2091-1891
authors.initials: B
authors.lastname: Franz
authors.affiliation: Heritage College of Osteopathic Medicine, Department of Social Medicine, Ohio University, Dublin, OH, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Skinner
authors.affiliation: Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Kelly
authors.initials: K
authors.lastname: Kelleher
mesh_terms: D001061:Appalachian Region; D003299:Cooperative Behavior; D006780:Hospitals, Rural / Q000458:organization & administration*; D006801:Humans; D020380:Needs Assessment / Q000458:organization & administration*; D009820:Ohio; D009939:Organizations, Nonprofit / Q000458:organization & administration*; D058991:Patient Protection and Affordable Care Act / Q000331:legislation & jurisprudence*; D024382:Professional Role; D011634:Public Health; D015980:Public Health Practice; D064890:Social Determinants of Health; D014481:United States
keywords: Affordable Care Act; Appalachia; community benefit; community health needs assessment; evaluation; hospitals