There is something of the Pareto Principle—the "80/20 Rule" by which 80 percent of consequences stem from 20 percent of causes—in how our healthcare system has approached social determinants of health (SDoH). Namely, while SDoH have been shown to be key drivers of more than 80 percent of health outcomes, only 20 percent of the U.S. healthcare budget goes to services that address them.
But the good news is: that's beginning to change.
With the U.S. continuing to spend more per capita on healthcare than any other country, payers and providers are increasingly eager to find more effective, lower-cost models, and partnerships with community-based organizations (CBOs), whose work directly addresses those SDoH, are chief among them. But zooming out for a moment, what's the view from the other side of the table? From the standpoint of CBOs, what's in it for them?
Three good reasons—access to funding, the capacity to scale, and broader community impact—come to mind right away. Let's break them down one by one.
1. Access to funding
Today, most CBOs depend for their subsistence on a welter of sources: grants, philanthropies, governments, foundations, and more. It's a precarious existence, to be sure, despite the tremendous importance of the work they do—or all the more so because of it. As to that generalized precariousness, two findings from "A National Imperative: Joining Forces to Strengthen Human Services in America," an analysis of the financial health of CBOs across the country, should underscore the point:
- Many CBOs are currently running operating deficits.
- Many have limited or no financial reserves, meaning they're extremely vulnerable to unanticipated fluctuations in revenues or expenses.
This is perhaps the most obvious area where partnering with payers and providers could be a game-changer for CBOs. Decreased reliance on grants should open up new opportunities to scale core capabilities. And what's more, quantifiable, organization-based data around improved health outcomes, which would be the fruits of an effective payer or provider partnership, could then be leveraged to secure grants and new sources of funding down the line. You can see this playing out in New York City right now, in fact—existing partnerships between CBOs and payers and providers are dramatically expanded.
For CBOs trapped in a seemingly endless cycle of grant applications, these partnerships could be, at minimum, mission-amplifying complements to their current approaches to funding. And it is this "complementary" dimension we'll turn to next.
2. Scaling impact
Lower rates of pre-term births. Fewer interactions with child protective services. Significantly reduced 30-day hospital readmissions (along with cost-savings north of $17 million). These are only a few demonstrated examples of how strategic partnerships with payers and providers can enable CBOs to scale, amplify their impact over the near term, and ultimately offer more value in the communities they serve. Over the longer term, needless to say, their potential to drive meaningful change appears almost limitless.
Interestingly, on that note, there's evidence that when CBOs and payers or providers do enter into partnerships, those partnerships only grow stronger over time. In part, that may be because these partnerships leverage each party’s unique strengths—and therefore unlock efficiencies and value that neither would be able to realize on their own. For example, many providers have platforms that can distinguish between met and unmet patient needs. CBOs, connected with these insights, can eliminate redundancies in their offerings, avoid being stretched too thin and truly offer patients coordinated community-based care.
Add to that the findings, taken from a different study, that CBOs engaged in partnerships with payers and providers deliver about three services per contract on average. Think about what that means in terms of impact. By delivering multiple services through these partnerships, CBOs can increase the number of touchpoints they have with patients in the communities they serve. That's a recipe for ramping up impact, engaging more patients, and providing greater value to the community at large. And that's a win-win-win.
3. Wider community exposure
Partnerships, beyond amplifying the depth of impact for CBOs, can also serve to expand their reach. And you might be surprised by some of the ways this plays out in practice.
Referral networks are a good example of that. Through referral networks—thanks to their partnerships with CBOs—payers and providers can more consistently connect patients facing SDoH-related health barriers with CBOs that are in the best position to address their needs. Put that together with patient-level data sharing, what's more, and it means real-world health outcomes can be reliably tracked and measured across each one of these touchpoints, helping all parties to identify gaps and drive broad-based improvements over time.
Another example: shared-savings arrangements, which incentivize payers and providers to cultivate partnerships with CBOs, as CBOs can address key SDoH factors affecting population health. What's more, shared savings can be used to create financial incentives for CBOs to become involved in a provider’s care delivery—meaning, again, a wider footprint for a given CBO. In turn, that should translate to the best possible outcomes for all patients and for the community the CBO serves.
There are several compelling reasons why CBOs should start exploring partnerships with providers or payers, as we've discussed here. But to fully realize the benefits of those partnerships, CBOs have an active part to play in initiating them. And for many CBOs, that can be where the real challenges begin. For example, you'll need to have a more nuanced understanding of the types of partnerships available. You also may need to know how different financial models work, what metrics are going to matter most in the eyes of providers and payers, the ins and outs of shared-savings arrangements—and more.
Fortunately, we've put together some resources to make all of that a little bit easier. Just check out our comprehensive white paper, "Going Beyond Grant Funding." It's got everything you need to know to help you scale your CBO, elevate your impact, and reach a broad audience in your community than ever before.