During our first 18 months, HealthierHere worked to secure funding to improve health equity in our region. Now that we’ve earned some of that funding, we face the challenge of deciding how best to focus our resources for the most effective and sustainable impact.
We approach this work with the humble knowledge that, even with the millions we’ve earned, it is not nearly enough to invest in all that our region needs. We also recognize that as a collaborative organization with diverse stakeholders, there will inevitably be different perspectives about what is most important. With that in mind, and with help from Manatt, our team developed an innovative tool to bring objectivity to the process of prioritizing which investments are most aligned with our values and our Pay-for-Performance goals. We’ve put together this brief overview to help you understand how we’ve approached this and where we are in the process.
By necessity, we are starting with clinically focused innovations. It is important to know that this is a function of timing, not commitment. There is separate and substantial funding specifically allocated for community-based and social service organizations, set aside by the Governing Board. We are in the process of identifying community partners now and when that is complete, we will be prioritizing and evaluating the options for community investment.
Many great options. With input from design and work groups, assessments and change plans submitted by our clinical partners, we identified nearly two dozen potential investments for 2019 – all of which are necessary and important. Given our limited available resources and the time it would take to evaluate and cost-out each option, the need to prioritize and narrow the focus to a smaller list was critical. That was the goal of the Investment Prioritization Tool (IPT).
First Gate: Leading with our values. The tool uses a gated model. First, each investment was evaluated based on its alignment with six shared values that were vetted and weighted by HealthierHere’s Governing Board, committees and staff:
Equitable • Innovative • Viable • Systemic • Leveraging • Sustainable
Only investment strategies that performed in the top 50% made it through the gate and moved forward in the process, assuring that any options we choose are closely aligned with our values.
Second Gate: Sustaining our work. Investment strategies that made it through the Values gate were then evaluated on their ability to help us meet our Pay for Performance (P4P) metrics. That’s essential, because our ability to earn future funding for our region is dependent on improving outcomes – many of which are not directly related to the project portfolio.
Feedback on the Prioritized List. The scores for values and P4P were combined and weighted, creating a ranked list of 12 investment priorities, almost all of which are systemwide (rather than organization-specific). We sought feedback and guidance on the list, bringing together our Community & Consumer Voice, Finance, Performance Measurement & Data, and Transformation Committees twice in late 2018 and once in January. We discussed the IPT process and the list and dug into HealthierHere’s potential roles in supporting health care delivery system improvements. One of the key points of feedback was the overlap between several of the strategies and the need to think about them in a more holistic way.
Weighing the costs. With the approval of the committees and the governing board, the list of 12 options moved forward to the final step in the prioritization process: identifying how much each option would cost and weighing how and when they would impact our ability to achieve our goals, then developing concrete investment strategies for 2019.
We are working on the financial analysis and strategic framework now, with recommendations to be presented at a final joint committee meeting scheduled in mid-February. HealthierHere’s Governing Board will receive the committees’ recommendation in March. Once the board has approved the 2019 investment strategy, we look forward to sharing it with you.
One final, very important note: we know that this is unique, complex work which does not come with any one-size-fits-all answers or guarantees. This is the first stage of an ongoing, iterative process. Over time, as we learn from our efforts, our strategies will evolve – and as we improve outcomes and earn more funding, we will have the resources to expand our investments.
If you’d like to learn more about HealthierHere’s Investment Prioritization Process, we invite you to join us for a live webinar and Q & A, February 14 at 11:00 am to 12:30 pm. Register for this live webinar event here.
Update: You can view the slides and a recording of the webinar here.