Many advocates for low-income communities expected major healthcare systems would be driven to boost their investment in community programs aimed at improving overall population health as more patients became insured and care moved to value-based payment.
And some of the nation's leading healthcare systems are moving in that direction. They are beginning to deploy their physician networks in innovative programs aimed at reducing the incidence of diabetes, hypertension and drug abuse, which undermine the health profile of the low-income communities they serve.
Great Neck, N.Y.-based Northwell Health, for instance—which over the past two years has added hospitals and physician practices in low-income areas of Queens and Brooklyn to its suburban Long Island base—created an Office of Community and Public Health as early as 2012. The goal was to narrow the health disparities between the poor and affluent communities it serves.
“It was no longer acceptable to us to just run our practices and run our hospitals and not provide opportunities for heightened education on prevention and wellness to be really respectful of diversity and health literacy concerns,” said Dr. Stacey Rosen, vice president of women's health at Northwell's Katz Institute for Women's Health.
Rosen said a key component of Northwell's initiative has been the role its physician workforce of more than 2,300 has played in conceptualizing and implementing its community benefit programs. One of the system's larger efforts has been an education outreach campaign intended to help community members make better food and lifestyle choices to lower their risk of developing severe cases of diabetes, hypertension and heart disease.
But the size of its investment in community health still isn't large. And that appears to be the case at most major healthcare systems and their physician networks. And at some, investment in community health is even shrinking.
One reason: the financial incentives behind maintaining their tax-exempt status have yet to substantially change, while the move to value-based care reimbursement—which will drive a greater emphasis on prevention—is just getting started.