Leveraging Community-Driven Anchor Activities Among US For-Profit Hospitals

Abstract

Hospitals have the ability to serve as anchor institutions that not only provide clinical care but make important community investments through employment, and outreach, and engagement efforts that address the social determinants of health. In doing so, hospitals may partner with community members and community-based organizations, but the extent to which local residents participate in directing local investments varies across organizations. This study looks at the role of hospitals as anchor institutions and the best practices for leveraging community participation in planning investments to improve social and economic health in communities. We used an inductive, qualitative approach to understand the incentives hospitals have to anchor themselves within their communities and how best practices can be leveraged. We conducted 28 in-depth interviews with 27 hospital leaders and personnel, and one interview with a member of a for-profit hospital advocacy organization. Drawing on thematic analysis, three primary themes were identified as critical to leveraging community-driven anchor activities: strong and intentional community-oriented leadership; direct community involvement; and non-regulatory incentives, including incentive programs. The more institutions, organizations, communities, and individuals expect community-oriented anchor activities from hospitals, the more likely they are to engage in such activities. Critical to this work is ensuring that community members themselves are able to help direct the investments of hospitals in alignment with community health needs. Community stakeholders, including elected officials, public health offices, and policymakers, have important leverage in creating expectations for hospitals to engage in anchor activities and facilitate community-based partnerships as a part of this process.