This report describes the assessment of the Hospital Community Cooperative (HCC) to identify the effects, benefits, and lessons learned from the HCC's effort to bring together hospitals and community organizations to collectively address key social determinants of health in their communities and promote health equity.

Early Learnings from the Hospital Community Cooperative of the American Hospital Association

Malcolm V. Williams, Laurie T. Martin, Jessica L. Sousa

ResearchPublished Feb 27, 2020

Health is increasingly understood to be shaped by more than individual genetics, clinical care, and health behavior. Structural factors that shape the distribution of power and wealth in society are also responsible for health inequities, and social determinants of health (SDOH) have overlapping impacts on health outcomes and well-being that account for approximately 70 percent of the variance in health status.

Hospitals and health systems are also facing challenges related to (1) regular use of the emergency department for nonemergency care and social service needs and (2) new payment and care delivery models that shift financial incentives for providers toward achieving and maintaining the health of their patient populations. Collectively, these trends point to an opportunity to think differently about the role of hospitals and health systems in the improvement of population health. Recognizing the value of partnered approaches, the Hospital Community Cooperative (HCC) aims to bring hospitals and community organizations together to collectively address key social determinants of health in their communities and promote health equity.

This report includes key findings and lessons learned that should be of interest to various audiences seeking to expand the capacity of hospital-community partnerships to address SDOH, including other hospitals, other health systems, and community partners seeking to leverage the support and resources of their local health care institutions (whether these approaches are occurring within a formal HCC or not). In addition, this report should be of use to foundations or other funding agencies that might support similar partnered approaches to improve health inequity in their communities.

Key Takeaways

The planning year was intensive for most teams

  • Developing key partnerships between health systems and community partners and planning for implementation were time intensive.

Participation in the HCC increased capacity to address SDOH among some teams

  • Few teams reported an increase in leadership prioritization of health equity; however, several reported an increase in hospital resources provided for such efforts.

Teams participating in the HCC reported strengthened partnerships over time

  • At the end of first year, eight of ten teams felt that they had the right types of partners.

Some teams reported strengthened data infrastructure and data systems alignment

  • Despite the longer time investment, many teams developed solutions that allowed for data-sharing in a manner that promoted a coordinated system of care while maintaining the privacy of individuals.

Teams appreciated the flexibility of HCC funding and protected time to work on projects

  • Teams each received $10,000 and valued the ability to invest the dollars in their project with no restrictions on how the funds could or could not be spent.

Participation in the HCC has had a positive impact for most teams

  • Several strengthened their capacity to address SDOH and health.
  • Some teams also reported increases in leadership support and resource investment for health equity and that they had strengthened partnerships while participating in the HCC.

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Williams, Malcolm V., Laurie T. Martin, and Jessica L. Sousa, Early Learnings from the Hospital Community Cooperative of the American Hospital Association. Santa Monica, CA: RAND Corporation, 2020. https://www.rand.org/pubs/research_reports/RR4390.html.
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This research was funded by the Aetna Foundation and conducted in the Community Health and Environmental Policy Program within RAND Social and Economic Well-Being.

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