NCP Guidelines: Domain 1 - Structure and Processes of Care
December 8, 2018
How to Conduct a Community Needs Assessment
May 23, 2018
Before creating or expanding a service line, such as home- or clinic-based palliative care, it's important to have an in-depth understanding of the population(s) you hope to serve as well as the market in which the service will be offered.
For example, an organization recently contacted me about conducting a feasibility study before they start or acquire a private duty company. They understand the importance of determining the need in the community and selecting the community(ies) with the highest unmet need for the services.
What is a Community Needs Assessment?
A community needs assessment answers these questions:
Who needs these services?
What are their specific needs?
Is anyone else meeting those needs?
Do their needs align with our strategic objectives and mission?
Do we have the capacity to meet those needs?
Who can we partner with to meet their needs?
What reimbursement can we receive for these services?
The information gathered during the community needs assessment provides your organization with a framework for building a service line that meets the needs of those you hope to serve. The needs assessment also points to potential reimbursement sources, including contracts with other providers, Medicare/Medicaid reimbursement, shared risk partnerships, and contracts with payers to manage a population on a per member per month basis.
The bulk of the needs assessment is comprised of data specific to your community. Each state has data available through their website, typically under the purview of the Department of Aging or Department of Health. Below is a list of several data sources I use when conducting a needs assessment. The data sources selected for a specific needs assessment is based on the program goals*, the available data, and the project budget.
Hospital community health needs assessments
State data including:
Department of Aging county profiles and projections
The data collected is specific to the community and project goals. In addition to the data sources listed above, it's important to look at the services provided by other organizations in your community. If you identify a need for a private duty service, based on population data, you might be inclined to develop or acquire a private duty company. It's possible, however, that other providers in the community can adequately handle the anticipated need for this service.
In addition to the data you collect, it is important to talk to internal and external stakeholders. When I conduct needs assessments for clients I always begin with a conversation with the leaders of the organization that has hired me. Typically the CEO and other members of the senior team. I also try to speak with community liaisons as they always have a pulse on the needs of referrals sources, which is key to building or expanding a service line. It's important to speak with the organization's practitioners (physicians, nurse practitioners, and physician assistants) as they are well connected in the community and it's important to have their buy-in throughout the process.
Examples of questions I've asked stakeholders include:
"Thinking about the community – what services do you think people need that could be addressed by the organization?"
"Are there specific parts of the community or groups of people who need these services most urgently?"
"Is there a program in the community, besides this organization, that is doing a great job in this area (aging services, community-based health care, etc)?"
"What organizations, if any, do you think would be receptive to a partnership to deliver a ___ (e.g., community-based palliative care or private duty service)?"
Needs Assessment Report
Once the data is all collected, the analysis begins. Looking for trends in unmet needs, underserved populations, demographic and health data, etc. The data from the interviews can provide information to inform your recommendations. As you can see from this Needs Assessment Table of Contents, the report creates a profile for each segment of the service area, in this case one county, summarizes the other data collected, and includes detailed and actionable recommendations to inform the organization's strategy.
* Read my article in the Journal of the Louisiana Mississippi Hospice and Palliative Care Organization on Hospice in the Era of Post-Acute Care for a list of questions that can frame your organization's program goals.