New Issue Brief from Robert Wood Johnson Foundation
“Improving Community Health by Strengthening Community Investment: Roles for Hospitals and Health Systems”
“Hospitals and health systems have an array of non-clinical assets—from their ability to make loans to expertise in real estate, financial, and project management to significant property holdings—that can be leveraged not only for the benefit of the community but for their own benefit as well,” writes Donald Schwarz in the preface. “By thinking broadly and investing strategically, hospitals and health systems can be better partners in solving the most pressing issues in their community,” he adds.
A research team spent six years exploring — including hundreds of interviews — how communities in poverty could become healthier. More specifically, they found themselves asking, “What can communities do to make it easier to attract and deploy capital and leverage other assets to achieve their social goals?”
Among their key findings:
“Hospitals and health systems have a variety of assets—such as financial resources, land, and expertise—that would make them valuable participants in the community investment system; a small, but significant cohort of institutions have taken bold steps and engaged in investment discussions or transactions…”
“What we found is that the hospitals that have engaged in community investment were exceptional—to the extent that there is a trend in this direction, it is at an early stage. Movement from volume to value, which could drive such a trend, is still too nascent to command action, and metrics are not yet available or proven. Yet those institutions that have undertaken community investment are convinced that their early efforts have important strategic value and are very much worth doing.”
Setting aside other healthcare players, this paper looks exclusively at the initiatives of hospitals and healthcare systems, including several Stakeholder Health members: Trinity Health, Dignity Health, Children’s Health, and Henry Ford Health System. Community investments differ widely, from low-income housing to small businesses that create jobs.
And the investments are not limited to funds; some systems invest with their land, office space, their name and brand, as well as purchasing power. The research also found that hospitals can play a valuable role through leadership and convening.
The paper aims to do three things:
• Share examples of hospital community investment practices that inspire others to consider a broader range of options for addressing the social determinants of health than they might have imagined;
• Lay out a way of looking at the community investment ecosystem in a place so that health institutions interested in participating can understand the opportunities and challenges, consider possible strategies, and develop an effective approach; and
• Help communities that wish to engage their health institutions understand the motivations, constraints, and approaches that their potential partners might bring to the table.
The research identified several factors “critical in getting health systems to start and succeed with interventions.” These will sound familiar to those involved in Stakeholder Health:
- High level institutional champion and support;
- Understanding the range of possible interventions and investment approaches;
- Staff with non-traditional experience;
- Leveraging staff interest and capacity where it exists;
- Narrative that ties efforts to mission/goals;
- Finding partners in the community and taking time to build trust;
- Engaging the community in defining priorities; and
- Patience, modesty, and willingness to listen.
— Tom Peterson