Beyond Compliance: Reframing Community Benefit for Impact
What does it look like to move from reporting checkboxes to measurable, mission-aligned change? That question was front and center during Metopio’s recent webinar, “Going Beyond Community Benefit to Drive Broader Community Impact with Your Next CHIP,” featuring Nancy Lim, Director of Community Health Improvement at the Catholic Health Association (CHA) in conversation with Metopio CEO Will Snyder.
Together, they explored the evolving role of community benefit in health systems, new trends in collaborative CHNA/CHIP efforts, and strategies for tying implementation plans more tightly to evaluation and impact.
Here are four takeaways from the conversation:
1. Community Benefit is More Than a Compliance Exercise — It’s a Vehicle for Health Outcomes
The Catholic Health Association represents over 650 nonprofit hospitals and 1,600 long-term care and health facilities. As Lim explained, these institutions provide care to one in seven U.S. patients every day — and have a long-standing commitment to community benefit.
That commitment, she emphasized, is not just about filling out IRS Schedule H:
“It’s our mission, first and foremost. But it’s also compliance. And those two things need to be aligned.”
The CHA encourages hospitals to think about three levels of community impact:
Direct service (primary charitable purpose)
Community benefit activities
The “above and beyond” — partnerships, coalitions, and structural change
2. Hospitals and LHDs Share Parallel Requirements (and a Shared Opportunity)
Both hospitals and local health departments (LHDs) are required to conduct health assessments and improvement plans — hospitals every 3 years and LHDs every 5 years. This shared responsibility presents an incredible opportunity to align timelines, strategies, and data infrastructure across institutions.
With the growth of tools and technology to support hyperlocal focus, we can start drilling into questions like: Who is most impacted? Where are the greatest barriers?
Both speakers emphasized that without shared logic models and aligned evaluation frameworks, it becomes difficult to measure true community-level outcomes — and even harder to sustain long-term impact.
3. Collaborative CHNAs and CHIPs are Growing, but Ownership and Clarity Still Matter
Many communities are moving toward joint assessment processes. But Lim acknowledged that while collaborative CHNAs are increasingly common, true “community CHIPs” — where a shared implementation strategy is co-owned across organizations — are rarer and more complex.
She pointed to Billings, Montana’s “Healthy By Design” collaborative as a standout example, where hospitals, LHDs, and community-based organizations conduct joint planning, share data continuously, and hold each other accountable.
But she also underscored the value of coordinated (not necessarily combined) CHIPs: “Even if you’re not writing the same document, it matters that you’re in conversation. That you’re sharing, checking in, and not duplicating efforts.”
4. Continuous Process Improvement Is the Path Forward
One of the biggest pain points in CHNA/CHIP work is reaching the end of an implementation cycle without a clear evaluation framework in place.
“We've all been there,” said Snyder. “It’s the end of the cycle and you’re scrambling to show impact — but you’re stuck reporting outputs, not outcomes.”
To address this, Lim encourages embedding continuous process improvement from the start. That means:
Building a logic model alongside your CHIP
Creating space for quarterly (not just annual) check-ins
Asking the right questions: “Did we do what we said we would? Is anyone better off?”
Lim also offered four of her favorite reflective questions to guide ongoing strategy:
“Who’s benefiting? Who’s burdened? Who’s missing? Who’s deciding?”
Final Thoughts
Better health outcomes start with better questions — and better collaboration. As Lim put it, “If making people healthier were easy, we’d all be on a beach somewhere. But these are hard, sticky problems… and they require us to stay in it together.”
If you’re working on a CHNA, CHIP, or community benefit strategy and want to learn more about how Metopio can help, we’d love to hear from you.