New CDC Web Resource Puts Community Health Improvement Tools at Your Fingertips

June 09, 2015|2:30 p.m.| Megan Miller

As hospitals seek to comply with the Internal Revenue Service’s Final Rule on Community Health Needs Assessments (CHNAs) for Charitable Hospitals, they are required to solicit input from local, state, tribal, or regional public health. With this in mind, there are many opportunities for state and local public health to become more involved with the CHNA process and implementation strategies to promote improved community health in their states, cities, and towns. The CDC has created a set of tools to help with the collaborative process for community health improvement. The Community Health Improvement (CHI) Navigator ( is a unifying framework and source of tools and resources that public health agencies, hospitals, health systems, community organizations, and other stakeholders interested in improving the health of their communities can use.

The CHI Navigator emphasizes the importance of collaborative partnerships, providing tools and resources to support health systems in their move to value-based healthcare, underscoring the critical role of public health in the changing health system. A key feature of the CHI Navigator is a search engine/database that lets you identify proven, community-based interventions that can help move partnerships from planning to implementation and action, and, in the end, to improved community health and well-bein‎g. Significantly, the CHI Navigator highlights community health as an outcome and an approach, noting this definition includes approaches that may lead to optimal health outcomes for the whole community with a particular emphasis on reaching vulnerable/underserved populations that experience the highest burden of disease.

Following the launch of the CHI Navigator in early May, we asked Denise Koo of CDC’s Office of the Associate Director for Policy to share some highlights about the CHI Navigator and how state public health agencies can use the resources in their work in the states. While its development was motivated by the IRS’s requirement, the CHI Navigator serves many other needs for states seeking to influence upstream factors in improving community health. As Koo mentions, the CHI Navigator can also be used in population health improvement plans and accreditation. See our Q and A below.

Denise Koo

Denise Koo, MD, MPH, CAPT, USPHS, is adviser to the associate director for policy at the CDC. For more information, please visit the Community Health Improvement Navigator resource on CDC's website.



What makes the CHI Navigator different from other, similar resources? What value does it add?

The CHI Navigator is unique in the following ways:

Collaborative Stories with Quantified Bottom-Line Outcomes
The CHI Navigator provides succinct, focused examples of health systems partnering with others outside of the health care field, yet hitting bottom lines important to the health care system such as decreased admissions or readmissions, decreased emergency room visits, and increased per-patient per-month cost savings. These stories show the importance of collaborative partnerships to surviving in the new value-based healthcare system.

There are a great many lists of tools out there, but many of them are just that—lists, and very long ones at that. Our tools section “curates” the tools. We carefully reviewed hundreds of tools looking for ones that helped you both conceptualize and operationalize some key concepts (such as with templates or checklists). Also, the tools are presented to the user in a community health improvement–process framework, and provide some sense of what the tool offers and exactly where in the tool to go (not just the general URL for the tool, but what section or page).

Database of Interventions
This one-of-a-kind search engine pulls together evidence-based interventions from multiple sources. Many people don’t know that individual-source databases exist, much less how to find or comb through them for focused interventions that target their desired risk factor. We have done the work of identifying these sources, reviewing interventions from them, to make it easier for users to find interventions that work and that they can consider with their partners. We have tagged these interventions with certain filters to facilitate users identifying interventions of particular interest to them.

How did you ensure that the CHI Navigator’s contents are high quality and offer users the greatest-possible benefit?

We leveraged good work already done by others. The CHI Navigator is an aggregator and framer. For the database content, we drew from six, reputable source databases (e.g., The Guide to Community Preventive Services), that described how they rated their interventions with clear, defensible methods. We tried to be as systematic as possible and explicit and transparent about our approach.

How will this product help improve our nation’s health, especially of those who are vulnerable/underserved?

We hope that the CHI Navigator facilitates sustainable, effective collaborations among public health organizations, health systems, and community partners, helping them carry out upstream interventions, because these are the bedrock for our future community’s health and well-being and can help address health equity issues. We also recommend that as an early step in the community health improvement, partners identify and consider geographic areas of greatest need, and we point to a tool that assists in that step.

How can state health agencies best capitalize on this resource?

State health agencies can use the CHI Navigator’s examples, framework, and language to work with health systems and other partners to develop population health improvement plans, perhaps as part of their State Innovation Model grant efforts. They also can use the CHI Navigator to support their Community Health Assessments and Community Health Improvement Plans, as well as efforts toward accreditation. We included quotes from the IRS Final Rule on CHNAs for Charitable Hospitals to underscore the connection to the hospital community benefit work, but we think that much of the CHI Navigator can be helpful for discussions with hospitals about the importance of working with health departments for all of their work. The initial focus on high-prevalence, high-cost conditions underlying cardiovascular disease is anticipated to augment the impact of the Million Hearts Initiative.

Megan Miller is the director of health transformation, part of the health systems transformation team at ASTHO. In this role, Miller helps to lead ASTHO’s work to support state health departments involved in healthcare delivery and payment reform efforts. Additionally, she plays a key role in supporting activities that strengthen state health departments’ work with state Medicaid agencies. Prior to joining ASTHO, Megan served as the deputy budget director at the Massachusetts Department of Mental Health, where she provided budgetary support and leadership for a wide range of behavioral health programs and worked closely with the team charged with implementing SIM activities around behavioral health.