The mission of a hospital is to make the communities they serve healthier. That goal is not achieved through clinical programs alone. Increasingly hospitals and health systems are investing in social programs designed to keep people, particularly underserved populations, healthy.
RWJBarnabas Health, for example, has been attempting to address social determinants including food security, housing and unemployment. “We have made this concerted and overt effort to invest in social programs,” said Barry Ostrowsky, president and chief executive officer of RWJBarnabas.
“We specifically in the city of Newark, agreed to hire people who have been chronically unemployed to train them and to make sure that they have jobs – we pledged with the mayor to hire 350 people by the beginning of this year.”
Ostrowsky added that the organization has exceeded that number and continues to train people in a boot camp arrangement and place them in jobs where they can earn money for themselves and their families.
In addition, RWJBarnabas has invested in a greenhouse in Newark that grows fresh food where people are invited in and are taught the benefit of fresh foods and how they can be prepared at home.
In New Brunswick, RWJBarnabas is active in the community regarding food insecurity and goes into the schools at every level to teach about nutrition.
“These programs, whether it’s food insecurity or shelter or unemployment, are programs that don’t have reimbursement codes attached to them. We cannot bill people for them. We are using that which we’ve earned on the sale of health care services to support this,” Ostrowsky said.
He added that while these investments are not part of the conventional business of a hospital system or health care system, he believes that it is necessary for the organization if it is committed to improve the communities that it serves.
AtlantiCare is also addressing food insecurity, substance use, suicide-prevention, healthcare disparities and other social determinants of health.
- According to Lori Herndon, president and CEO, AtlantiCare has stepped-up its social programs initiatives including:
- Providing $22 million in charity care
- Conducting more than 150,000 suicide prevention screenings
- Ensuring patients in the community and emergency department connect with peer recovery specialists, who are available 24/7
- Distributing more than 336+ Doses of Narcan
- Contributing to the education of more than 120 medical residents, students and/or fellows
- Distributing $58,300 in Healthy Schools grants to schools in Atlantic, Cape May and southern Ocean counties
- Funding 44 school and community gardens
- Distributing 146,751 pounds of nutritious food through Panty at the Plex, Summer Lunch and Learns and Pop-up Fruit and Vegetable Markets
The state’s business community has been paying close attention to the social determinants programs launched by health systems. Ostrowsky said business owners and executives understand how the dynamics of these vulnerable communities create pressure on health systems, the deliverer of health care, and are asking them what they are doing about it.
“We have been addressing it for a number of years. It has gotten great reception by those financial folks. Everybody seems to want some level of attention, if not leadership paid to what it is we need to do to help people before they get sick and it is no longer just doing screening and offering some advice,” said Ostrowsky.
“It is getting involved in the very fabric of the community economically, socially, educationally to try and make life better for folks,” Ostrowsky added.
Hospitals and health systems believe the investment in social determinants will ultimately result in a win-win for them and the communities they serve.
“We expect that could happen and will happen in many different ways. The question is how soon,” said Ostrowsky. We believe as a health care reimbursement policy that eventually organizations like ours will have this financial responsibility to manage lives within a presumed budget.”
Ostrowsky believes that some of the programs will be self-sustaining.
“They won’t necessarily be a drain on the profit or the surplus or the net revenue that we create on the clinical side. We think the evolution will ultimately make for high value to these social programs in which we are investing.”