Creating Healthy Communities Together Community Benefit Update Dear friends, Health care for the 21st century requires us as leaders to expand the conventional health Donated care delivery model and partner with our communities to improve healthcare outcomes $1.4 billion — going beyond treatment of disease, and in community benefit focusing on its prevention. As the largest health care provider in New York State, Northwell is contributions a leader with the ability to deliver some of the most exceptional care in the world. And we are committed to providing the highest quality clinical care and building a culture of health and Offered more than wellness that affords all individuals an equal opportunity to live the healthiest life they can, regardless of racial, ethnic, geographic, 13,000 community socioeconomic or physical circumstances. health programs In 2018, Northwell hospitals invested more than $1.4 billion in programs, activities and resources — including free screenings, serving 5 million people immunizations, lectures, workshops and free or low-cost services — designed to promote the health and well-being of our neighbors. However, those of us in health care can no longer respond to health issues in our communities with traditional clinical solutions alone — clinical care is only one component that influences health. Ram Raju, MD, Senior Vice President and Community Health Investment Provided more than Officer; Jennifer Mieres, MD, Senior Vice President of Northwell Health’s Center for Equity of Care and Chief Diversity Officer; and Kristofer Smith, MD, Senior Vice 31,000 free President of the health system’s Office of Population Health Management, have health screenings and committed to investing in health-related social needs to improve health outcomes in our communities for the long term. Our Center for Diversity, Inclusion and immunizations to Health Equity continues to focus on educating and developing our employees in community members effective communication and cultural knowledge as part of an effort to deliver culturally sensitive care to patients as well as build strong community relationships. And, as this year has realized an unprecedented number of deaths and injuries from gun violence, Northwell has taken the lead in increasing awareness of gun violence as a public health issue. The Gun Violence Prevention Forum brought Trained together physicians, researchers, policy experts, health care executives, NYPD counterterrorism and victims’ advocates to share their thoughts on how leaders in 32,000 health care can address this national public health crisis. health professionals Hospitals have long served as anchors within their respective communities, bringing health, healing and hope to the people living in them. On the following pages you will see many examples of how Northwell is addressing the issues, eliminating the gaps and giving the vulnerable in our communities an equal chance to live a healthy life. For more information about Michael J. Dowling our community health President and CEO programs and services, Northwell Health visit northwell.edu Welcome Hospitals are often referred to as “anchor with our diverse communities to improve institutions” within their communities, not health care outcomes. Internally, Northwell’s only in delivering health care and promoting Center for Equity of Care established prevention, but also playing a role in the network-wide policies to incorporate community’s social and economic vitality. health literacy, language access and Ram Raju, MD Senior Vice President and For non-profit hospitals like Northwell, cultural competency as integral parts of Community Health there is a requirement to improve the health patient-centered care. Staff throughout our Investment Officer of the communities they serve. We are hospitals receive ongoing education that held accountable for our medical, social, fosters cultural humility, critical thinking environmental and fiscal impact. This and self-awareness in order to maintain requirement is known as Community Benefit. a fair, high-performing and inclusive Demonstrating proof of the programs and work environment. services we provide to keep our communities The hospitals within our regions continually healthy is not only how we maintain our develop strong partnerships with not-for-profit status, it is also how we fulfill community leaders and organizations and the mission of the health system to care for make every effort to respond to the unique the entire community, regardless of ability to needs of the communities they serve. We Joseph Schulman pay. Charity care, which is providing health listen closely to our partners, focusing not Senior Vice President, care for those who are unable to pay, is just a only on traditional forms of health care Population Health part of how we give back to the community. delivery, but also on the social issues that Northwell offers a vast array of Community affect our capacity to promote health equity Benefit programs and activities that promote — the conditions in which people are born, wellness and prevention of illness and chronic grow, live, work and age. conditions. However, we are acutely aware that there are striking differences in health Northwell is dedicated to providing outcomes in communities with poor social exceptional care and making a difference determinants of health, including unstable in the lives of people. We are a part of the housing, low income, unsafe neighborhoods greater good. Community Benefit is not simply a requirement at Northwell — it is or substandard education. We, as a health Eddie Fraser our calling. system, are deeply committed to partnering Vice President, Corporate Community Relations CHARITY CARE AND COMMUNITY ACTUAL $ BENEFIT CATEGORIES MM Community Benefit Contributions* Charity Care $240.40 Unreimbursed Medicaid $466.67 Community Health Improvement $33.22 Services and CB Operations Health Professions Education $326.01 Subsidized Health Services $237.30 Research $106.92 Cash and In-Kind Contributions $3.97 Northwell Health contributes $1.4 billion in Charity Care and Community Benefit (12.32% of operating expenses) Community Building $3.13 by participating in more than 13,000 community health programs and training 32,000 health professionals. TOTAL 2018 COMMUNITY BENEFIT $1.4 billion *Includes The Feinstein Institutes for Medical Research. Northwell Health 3 Introduction Northwell Health is a not-for-profit, multi-hospital, multispecialty health system with a proud history of raising the standard of health care for the more than 11 million people living in our communities. Northwell fulfills its vital mission to the within our communities, address the At Northwell Health, we are deeply community through Community Benefit challenges presented, and remove the committed to working in partnership activities, evidence of our ongoing barriers to equitable and sustainable with community members in order to investment in programs and services health care. We are proud to be one of four build a health foundation that is more that will meet the needs and improve health care organizations nationwide to be equitable, more comprehensive and more the health status of our communities. named honorees of the American Hospital effective — one that works to address Northwell is a member of the national Association’s Carolyn Boone Lewis Equity of the unfilled needs of our communities. Democracy Collaborative, which leverages Care Award for our efforts to reduce health Ram Raju, MD, Senior Vice President and our economic footprint to address drivers care inequities and advance diversity, Community Health Investment Officer; of local communities’ social determinants inclusion and respect in our workplace. Jennifer Mieres, MD, Senior Vice President of Northwell’s Center for Equity of Care of health through business/non-clinical Health care efforts account for only 10 and Chief Diversity Officer; Kristopher practices. The goal is to promote social to 20 percent of a community’s health Smith, MD, Senior Vice President of SVP, equity by increasing local hiring, buying and outcomes. Northwell is constantly seeking Population Health Clinical Transformation; investing at Northwell Health institutions. new and more effective ways of enhancing and Zenobia Brown, Vice President and As the largest private employer in New the community outreach and Community Medical Director of Northwell Health York State, our workforce consists of more Benefit activities that fall outside the scope Solutions, embrace the health equity than 70,000 people who serve a wide of traditional medical care. We recognize mission of Northwell and recognize that and culturally diverse geographic area. that addressing the non-clinical barriers we must adhere to the following principle: We use deliberate and strategic efforts to to health must be inextricably linked with “There’s no quality without equity.” continually train our work force to keep delivering state-of-the art medical services. pace with the changing demographics “ …outcomes are determined approximately 20% by clinical care and 80% by non-clinical factors, such as socioeconomic and environmental issues.” - Ram Raju, MD, Senior Vice President and Community Health Investment Officer 4 Northwell Health Promote Healthy Promote a Women, Infants Healthy and and Children Safe Environment Prevention Agenda Prevent Prevent Chronic 2019-2024 Communicable Diseases Diseases Promote Well-Being and Prevent Mental and Substance Use Disorders Source: Adapted from National