Our Beliefs
With a deep understanding of scientific research and years of frontline experience working in historically marginalized communities, we’ve always known that health begins where we live, work, eat, sleep, and play. But knowing that social determinants of health matter is not what sets HealthBegins apart. It’s knowing how to improve them — practically, boldly, and with an unwavering commitment to equity and justice.
Our Story
From 2012-2017, HealthBegins emerged as a national leader in the Upstream Movement, helping healthcare and community partners across the country through communications, network building, and hundreds of trainings on Upstream Quality Improvement — our signature braiding of social medicine and quality improvement approaches. As our team grew in 2017, so did our work and national impact. HealthBegins was selected to provide technical assistance to the CMS Accountable Health Communities model, a seminal effort to integrate social needs screening and referrals nationwide. At the same time, we expanded our work, helping many prominent national, regional, and state leaders in health care and the social sector move upstream together.
Our mission and work today remains clear — and is as timely as ever. We partner with and train courageous leaders to improve the social drivers of health and equity at all levels: individual social needs, community-level social determinants of health, and deeper structural determinants of health equity. That’s what we mean by “moving upstream.” We look forward to working with you.

Our Approach
At the root of our work is a clear understanding of what it means and what it takes to move upstream.
Through our communications and training tools, we help leaders and frontline caregivers to understand that “moving upstream” means continuously improving the social drivers of health and equity at all levels:
- Individual social needs, such as food insecurity,
- Community-level social determinants of health, such as food deserts, and
- Deeper structural determinants of health equity, such as redlining and structural racism.
We work with leaders across sectors to translate this understanding into action with clear strategies, learning collaboratives, and improvement campaigns, as well as place-based investment portfolios.
- In our strategic consulting work, we customize HealthBegins’ Upstream Approach — a set of practical strategic planning steps and tools — to each client’s goals and needs. We draw on years of experience developing social needs and social determinants of health strategies to provide keen insights, practical guidance, and support to help partners articulate and achieve bold goals.
- Our improvement campaigns and learning collaboratives are fueled by Upstream Quality Improvement — a blend of evidence-based performance improvement methods — as well as our team’s deep technical expertise in social medicine, public health, and implementation science.
- With our business and partnership development expertise, we help clients calculate financial and social returns and make the case for clinical-community partnerships. Using innovative investment planning tools, we bring cross-sector partners together to develop place-based Upstream Investment Portfolios that align a range of investments in social needs and social determinants of health with long-term health and economic goals.
Our Team

Dr. Rishi Manchanda, MD, MPH
President & CEO

Sara Bader, MCD, CPHQ
Senior Manager, Upstream Quality Improvement

Sadena Thevarajah, JD
Managing Director

Keandra Wilson
Project Manager

Grace Rubenstein
Editorial & Communications Director

Maricela Lopez
Executive Assistant

Vsem Yenovkian
Communications Associate

Toni Hancock Counts
Business Operations Manager/ Senior Project Manager

Roza Do
Consultant
