Ten ways one hospital tells its community benefit story (And how you can, too)

All of the nation's nearly 3,000 nonprofit hospitals are increasingly being called upon to defend their tax-exempt status by demonstrating, in a quantifiable manner, the benefits they bring to their communities. This contribution, collectively called "community benefit," is comprised of three core categories: charity care; health research, education, and training; and benefits directed at vulnerable populations and the community-at-large.

Telling this story and comparing one hospital's performance to another is not as simple as it might appear because there does not presently exist any uniform reporting standard or a universal method for calculating economic value. Accordingly, a growing number of state auditors are finding inconsistent data and are suggesting that statewide tax boards more closely monitor the situation in order to better determine true economic value. To that add the fact that a number of media reports, from the Los Angeles Times in December 2007 to the Wall Street Journal in April 2008, are calling for heightened awareness of this issue. Some even are questioning the profits being made by tax-exempt hospitals, which are intended to exist for public good.

Make no mistake, this issue is now high on our government's radar and is not going away. As a result, the American Hospital Association has taken the position that "hospitals should voluntarily, publicly, and proactively report to their communities on the full value of benefits a hospital provides."

We agree.

Huntington Hospital is a 600-plus-bed medical center in Pasadena, CA. Like many of our fellow nonprofits around the country, we are proud of the role we have played throughout our history (in our case, 115 years) as the community's central healthcare resource. Still, we also must candidly concede that our story as it concerns community benefit has not been told well enough, particularly at a time when all nonprofit hospitals need to be doubly prepared for public scrutiny. Recognizing this, last year we decided to embark on a multi-pronged communication program designed to reach all of our targeted audiences including the board, employees, medical staff, volunteers, donors, regulators, legislators, and the community-at-large. This communication program is aimed at educating all of these groups by clearly articulating Huntington's contribution in this area and reaffirming the value we serve as a nonprofit hospital existing for community good.

Our communication program is comprised of the following 10 ingredients:

1. As with all good public relations programs, we began by developing a set of key message points that tell our story in a compelling and understandable way. These points have become the backbone of our entire communication program and help ensure consistency of and focus on the message.

2. We know that a well-informed board can serve as ambassadors on our behalf. As a result, we spent time at a board meeting explaining what community benefit is all about, showing Huntington's contributions in this area and discussing how we track performance on an ongoing basis. Now, we intend to report back to the board throughout the year and be held accountable for how we are doing.

3. To instill both an understanding of and an appreciation for community benefit, we have made it an important component of our employee forums, we educate new employees about it in orientation, and we give an annual update on the topic at our annual state of the hospital address. Our goal is to make sure that every employee understands how community benefit is woven into the fabric of our institution and recognizes the role they are expected to play in embracing this mission.

4. We updated our fact sheet, "quick guide," and standard hospital boilerplate (part of all news releases) to include a reference to community benefit. Our addition reads: "Consistent with its nonprofit mission, last year Huntington Hospital provided approximately $44.7 million (or 11% of our revenue) in recognized community benefit through uncompensated care, medical education and the provision of much-needed services (including trauma care) not found anywhere else in the region."

5. We produced a simple brochure on community benefit, showing in real numbers the contribution Huntington makes to our community each year. Beyond discussing the three core areas, the brochure also speaks about other critically important services the hospital provides that would be absent from the community were it not for our ongoing commitment of resources. These "unduplicated services" include an annual $51 million to support such programs as trauma care, geriatric psychiatric services and a level three neo-natal intensive care unit, plus another $32.4 million of additional support to the Medicare population (making our hospital's total "giving back to the community" $128.1 million annually). These brochures are now available in the hospital's lobby, at community fairs, etc.

6. Our winter 2008 newsletter mailed to employee homes featured community benefit as its cover story. Beyond that introductory article, throughout the year we intend to look for opportunities to reinforce the concept of community benefit – such as in articles that speak about continuing medical education or expansion of our trauma services.

7. Concurrent with the timing of the employee newsletter, we developed an article for the monthly medical staff newsletter on the subject of community benefit, explaining its importance and quoting our chief medical officer showing his support.

8. We are re-examining the way we treat the topic of community benefit in our annual report, and are committed to using that vehicle to more completely tell our story in a fully transparent way.

9. In December 2008 we wrote and placed in our local newspaper a commentary asking residents to consider our hospital for their year-end financial giving. Included in that message, we spoke about community benefit—explaining what it is and making the case as to why financially supporting our hospital is so critically important, especially during these uncertain economic times.

10. We looked at all opportunities to leverage online media to help tell this story. Like many other hospitals, Huntington is becoming more and more familiar with the expanding opportunities using social media and, as the months unfold, we anticipate tools such as LinkedIn, Twitter, and blogs to become a vital part of our overall communication efforts. But even now, we are leveraging online communications to tell this story by adding information on community benefit to the "neighbors' page" of our Web site and providing information on community benefit as part of our web site's discussion of the hospital's ongoing community outreach programs.

Throughout 2009 and beyond we intend to keep the momentum going, using these tools and all others at our disposal to positively tell our story. The challenge to do so—and to remain true to the tenets of community benefit—will be unprecedented given all that nonprofit hospitals need to tackle in today's economy, from shrinking philanthropic dollars to caring for an increasing number of patients who simply cannot pay their bills. And so, we have reached a time when nonprofit hospitals are both needed more than ever to serve community good and are challenged more than ever to demonstrate responsible fiscal stewardship.

For any hospital marketing team looking to put together its own plan for communicating community benefit, here are six questions you may want to ask to ensure that there is clarity and consensus before moving forward.

1. In addition to knowing how you are doing in the area of community benefit, do you have comparable data for other hospitals in your area or state? What do you know about the nation's top performing hospitals in this area and how does your hospital compare?

2. Are there any years where your hospital's level of community benefit has decreased and, if so, how is that communicated?

3. Does your hospital make its community benefit report available to the public? If not, would the hospital consider doing so in the report's current form or in an abbreviated version? Would the hospital post it on its web site?

4. Is there anything additional that your hospital could be doing in the area of community benefit while still operating in a financially prudent way?

5. Is there a potential downside to promoting your hospital's performance in this area, such as attracting a disproportionate number of charity care cases to the hospital?

6. Is your hospital prepared to discuss the topic of community benefit should the media call, and who would serve as spokesperson in those cases?

The bottom line is that being a community healthcare leader means more than providing state-of-the-art healthcare. It means striving to make a difference and working to actively address vital community healthcare needs.

Legally, all not-for-profit hospitals are required to quantify the benefit they bring to the community in exchange for their tax-exempt status. While there are no consistent rules nationwide on how this is to be measured, broad standards do exist and there is talk of legislation being introduced this year to provide some clearer guidance on the issue.

Whether legislation is enacted or not, all nonprofit hospitals should continue to focus on providing the best care possible and in reinvesting back into the community to ensure that those we serve have access to the right care at the right place at the right time. Doing so is part of our collective mission and our heritage. And proactively communicating these community benefit efforts with the kind of transparency that makes our industry proud is simply the right thing to do.