Nonprofit and Public Hospitals Lead the Way in Collaborative Partnerships for Population Health

This study published in Health Services Research examines how hospital and county characteristics influence the breadth and depth of partnerships with various organizations to improve population health, revealing that nonprofit and public hospitals have stronger partnerships and community social capital plays a significant role in fostering collaborations. 

Population health management has gained prominence in recent years, particularly with the implementation of the Affordable Care Act (ACA). Hospitals are now encouraged to adopt proactive strategies to improve the health of the populations they serve through cross-sector partnerships that aim to address social determinants of health (SDOH), improve care coordination, and leverage the expertise of health care providers and community organizations. Studies have shown that formal alliances between hospitals and community organizations can lead to more successful collaborations by defining expectations and aligning financial incentives. 

The study utilized data from the 2017-2019 AHA Annual Survey and the 2018 Geography of Social Capital to analyze hospital partnerships in the US. The unit of analysis was the hospital, and all non-federal hospitals were included in the sample. The study categorized hospital partnerships into 4 types and measured the breadth and depth of engagement based on collaborative activities reported in the AHA survey. The publicness of hospitals was assessed based on ownership status, funding sources, normative measures such as teaching status and accreditation, and cultural orientation.  

Additionally, the social capital index was used to compare levels of social capital across different communities in the US. The study controlled for organizational size, system membership, hospital location, acute care status, county competition, and social capital in the analysis of hospital partnerships. Hierarchical linear models were used to assess the variance in the breadth and depth of hospital partnerships attributed to the hospital and community levels. 

The study examined hospital-community partnerships in 4129 unique hospitals across 1979 counties over 3 years. Hospitals reported a mean breadth of 6.46 partnerships and a depth of 2.34 partnerships. Nonprofit and public hospitals provided a greater breadth and depth of partnerships compared to for-profit hospitals. Teaching hospitals, hospitals in bundled payment arrangements, and those with community outreach showed greater breadth of partnerships. Community social capital was positively associated with breadth of partnerships. 

“An environment that promotes collaboration between hospitals and organizations to improve population health may impact the health of the community by identifying health needs of the community, targeting social determinants of health, or by addressing patient social needs,” said researchers. “However, findings suggest that publicness dimensions at an organizational level, which involves a culture of public value, maybe more important than county factors to achieve community building through partnerships.” 

Reference

Puro N, Cronin CE, Franz B, et al. Differential impact of hospital and community factors on breadth and depth of hospital population health partnerships. Health Services Research. 2024;59(S1):e14238. doi:10.1111/1475-6773.14238