Shared Health Needs Assessment and Planning Process


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The 2010 Patient Protection and Affordable Care Act requires that nonprofit hospitals periodically conduct community health needs assessments (CHNAs). These assessments help hospitals evaluate the health needs of a community and better understand key health drivers and underserved populations. The process also helps to prioritize community needs and identify strategies to address them.

The project was a collaboration between the Maine Center for Disease Control and Prevention (CDC) and the four largest hospital systems in the state: Central Maine Healthcare; Eastern Maine Healthcare Systems; MaineGeneral Health; and MaineHealth. This project was established to create a consistent statewide community health needs assessment and allow organizations to use limited resources effectively. Specifically, the goals of the project were to:

  • Address community reporting needs of hospitals
  • Support state and local public health accreditation efforts
  • Provide valuable population health assessment data for a wide variety of organizations concerned with the health of Maine’s communities and citizens
  • Fulfill regulatory obligations impacting public health efforts throughout Maine

Market Decisions Research helped lead the SHNAPP project effort in collaboration with the five major partners. MDR collaborated with the stakeholder workgroups and Maine CDC epidemiologists to develop a comprehensive analysis plan to determine what data would be analyzed and reported. Ultimately, 160 different health indicators were included and analyzed by key demographic and socioeconomic sub-groups. These were from various secondary sources, such as the Maine Behavioral Risk Factor Surveillance, the US Census, Maine Health Data Organization, Maine Integrated Youth Survey, National Center for Health Statistics, Maine Cancer Registry and the National Electronic Disease Surveillance System.


Working with the stakeholder workgroups and Maine CDC epidemiologists, MDR obtained the data, standardized formatting, analyzed the data and reported on results. The results were reported overall, by public health district, county and key urban areas. MDR created county and public health district summaries of all health indicator data with comparisons to the state of Maine and the U.S., where available, as well as year-to-year trends for every county in the state.

MDR also developed a comprehensive data documentation list by county, state and U.S. detailing data sources, years of availability and descriptive notes to assist with interpreting the data and identifying statistically significant differences.

In addition to the analysis of health indicators, MDR conducted a statewide survey to collect information about the health issues and social and environmental determinants of health. More than 1,600 surveys were collected from community stakeholders representing all types of industries and counties in Maine. The information from the survey was used in the assessment to help strategize actions needed to improve health status and set community health priorities for every county in the state.

MDR created individual CHNA reports for each of Maine’s 16 counties that included results from the 160 quantitative indicators, comparisons to the state and U.S., priority health needs and issues from the stakeholder survey results and information about community health rankings.

CHNA results were presented at community health forums around the state and used to facilitate discussions about health needs of the community and plan the next steps in the process. The statewide and county reports were placed on the Maine CDC website and have been freely used by various organizations for planning purposes. In addition, hospital systems used the reports to create entirely custom reports for each hospital in their system, making comments on progress on past objectives and outlining future plans.

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Maine’s Shared Health Needs Assessment & Planning Process (SHNAPP) Project, was the first public-private partnership of its kind in the nation.

Health Indicators: Oral Health | Respiratory | Cancer Cardiovascular Disease | Diabetes | Environmental Health | Infectious Disease | STD/HIV | Intentional Injury | Unintentional Injury | Occupational Health | Mental Health | Physical Activity, Nutrition, Weight | Pregnancy, Birth Outcomes | Substance, Alcohol Abuse | Tobacco Use

Patrick Madden, MBA - Practice Leader

Patrick Madden