Studies have shown that recent changes in the health care environment have reduced support for the health care safety net and public health services. Specifically, physicians who depend on managed care for at least 85% of their patients provide half as much free care as do physicians who do not participate in managed care. As health care resources are squeezed, questions arise regarding the role of managed care organizations and hospitals in supporting the public's health and the health care safety net.
Community benefits are the activities and contributions that HMOs and hospitals provide to their communities that benefit the public's health. Under the purely voluntary program, HMOs and hospitals assess the health care needs of their community, identify a target population, develop programs to serve those needs (or support existing programs) and file annual reports available to the public. HMOs and hospitals involve the community at every phase of the community benefits process. Reports include program descriptions, levels of funding and evaluations of the programs' effectiveness in addressing the identified health needs. Report summaries identify successful programs for duplication elsewhere in the state. Typical programs include AIDS prevention efforts, health screenings, domestic violence awareness initiatives, substance abuse prevention programs, and subsidized health care premiums for the uninsured.
At least ten states have developed community benefit reporting. Massachusetts has the best-developed program - HMOs and hospitals report spending $6.8 and $286.6 million each annually to improve the health of Massachusetts communities. Reporting in Massachusetts is voluntary, but every institution participates. Some HMOs have developed community benefits initiatives in response to reporting; others have been able to maximize the effectiveness of their existing programs. Reporting has improved the relationships of the institutions with their communities. Aetna, CIGNA, and ConnnectiCare file reports in Massachusetts and operate in Connecticut.
Community benefit reporting will improve access to quality health care for all Connecticut residents and reduce costs by preventing disease. Community involvement in health care policy planning will not only improve public relations and the quality of planning but will also lead to better integration with existing community resources - maximizing the effectiveness of health care resources that are becoming more and more scarce.