May 2019: Time to manage upstream programs like investments


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Vol 2 Issue 5

Dear friends,

From Virginia and Vermont to Colorado and California, I’m inspired by the leaders we support these days. I’m excited by the upstream efforts they’re driving in their systems and communities. With the help of new resources, they’re communicating and collaborating across sectors with more clarity and rigor than ever. With so many new programs and initiatives in the field, there’s good reason for us all to be excited — while still early days, work to address social needs and social determinants of health at scale is now underway.

Now, as I look ahead, I believe the time is right to broaden our approach. It’s time to manage our upstream programs as investments.

Let me explain.

When it comes to planning for the future, my wife and I are like a lot of folks. We have (and try to stick to) a budget and a basic plan for a couple of specific savings goals, like sending our kids to college. Beyond that, our time is spent on the day-to-day — spending time with family, doing good work with great colleagues and being part of our community.

Not long ago, recognizing that we needed to be more proactive in meeting our family’s long-term goals, we scheduled time with a financial planner. To be honest, it was the first time in recent memory when we both sat down and asked ourselves…is the way we’re spending and investing our resources putting us on a path to achieve our long-term goals? It was a humbling experience and fundamentally expanded our approach to setting and meeting our long-term goals.

When it comes to planning for the future of upstream work, the analogy holds. Through community partnerships and collaboratives, healthcare organizations are launching programs to address social needs and social determinants of health. We have budgets and plans to reach specific goals, like increasing screening or reducing ED visits. Beyond that, our time is spent on the day-to-day — building and managing upstream programs, doing good work, and building partnerships. When we contemplate “ROI” and “business case”, we’re often doing it one program at a time.

But is the way we’re spending and investing our resources putting us on a path to achieve long-term goals for community health? At the moment, the short answer is no. And one reason is this: As we’re busy designing and managing new upstream initiatives, we’re treating them as individual programs, not as investments within a broader portfolio.

As this movement matures, institutions, multi-sector collaboratives and entire communities face the challenge of taking a bundle of interventions purporting to address a variety of social determinants and shaping them into a cohesive investment strategy that can achieve long-term health, social and financial impact.

Moving from a “program” to an “investment” perspective is not just semantics. It’s about equipping ourselves with the skills and tools to become better stewards of resources. Just as financial planners provide support and tools to help families set long-term goals for college and retirement, HealthBegins and its partners are committed to supporting healthcare and community leaders with “upstream investment planning” tools and services. Our goal is simple: Ensure that today’s HRSN and SDH programs drive long-term sustainable health improvements for our patients and communities. In our June Webinar, Lauren Taylor and I will be talking about new structures and tools to do just that.

We have reason for optimism. Leaders across the country are finding new ways of providing and paying for interventions that address social needs and social determinants of health. As HealthBegins helps them launch and manage these new HRSN & SDH programs, we are asking these leaders new questions…ones that I now share with you:

What are your long-term goals for social determinants of health? Are your interventions aligned to support these goals? In short, what does your Upstream Investment Portfolio look like?

We’d love to hear your thoughts.

 

Best,


Rishi Manchanda

This newsletter greeting is adapted from a new blog post. Read more.



From The Upstreamist, the HealthBegins Blog:

Time to Manage Upstream Programs Like Investments

Through partnerships and collaboratives, healthcare organizations are launching programs to address social needs and social determinants of health. We have budgets and plans to reach specific goals,  but is the way we’re spending our resources putting us on a path to achieve long-term goals for community health? At the moment, the answer is no. In this blog post, Rishi Manchanda outlines why it’s time to view upstream interventions as investments for long-term financial, health, and social impact.
 

Unmuddying the Waters: A Webinar Recap

On April 24th, we hosted a webinar entitled “Unmuddy the Waters: Healthcare and Social Services Integration”. This blog post summarizes and pulls from that event.

If you missed it, you can watch the webinar here. Note: You’ll be asked to input some information in order to access the video. The webinar is a little over an hour long.

Upstreamist in Action: In a Texas Clinic, Lawyers Are Health Care Providers

Upstreamist in Action: When a patient at People’s Community Clinic in Austin, Texas, needs something more than routine care, her provider can refer her to the typical roster of specialists: a cardiologist, an orthopedist, a gastroenterologist. Plus one that’s far less typical: a lawyer.

Mincing Words: Making Sense of the Social Determinants of Health

With so many organizations getting interested in addressing the social determinants of health, the definitions can get muddy. In this recent interview and video with the Institute for Healthcare Improvement, HealthBegins founder Rishi Manchanda clarifies the meaning of this crucial work and connects it with pursuit of the Triple Aim and joy in work.

Watch for an invite to our June webinar:


Investing for the future: New ways for institutions and communities to pay and manage their upstream investments
Tuesday, June 25 at 11 a.m. PST / 2 p.m. EST

Through community partnerships and collaboratives, healthcare organizations are launching programs to address social needs and social determinants of health. We have budgets and plans to reach specific goals, like increasing screening or reducing ED visits. But is the way we’re spending our resources putting us on a path to achieve long-term goals for community health? At the moment, the answer is no. And one reason is this: As we’re busy designing and managing new upstream initiatives, we’re treating them as individual programs, not as investments within a broader portfolio. Join us on June 25th to hear national experts discuss new ways for institutions, multi-sector collaboratives and entire communities to shape their interventions into a cohesive investment strategy that can achieve long-term financial, health, and social impact.
 

Register Here

Speakers:

  • Rishi Manchanda, MD, MPH, President, HealthBegins

  • Lauren A. Taylor, MPH, MDiv, Doctoral Student in Health Policy, Management, Harvard Business School

By the end of the webinar, participants will be able to:

  • Describe financial and sustainability challenges and pressures facing institutions and communities seeking to improve SDH
  • List at least two ways in which “investment portfolio” and “trusted broker” concepts relate to their own work 
  • List at least two new approaches that institutions and communities can try to better manage, finance, and sustain SDH interventions

Cost: This webinar is free!

Can’t attend the live event? By registering, you will be able to access a recorded version of the webinar later.

Questions? Email us at info@healthbegins.org.
 

Interested in more webinars from HealthBegins? You can find recordings of all of our past webinars here.

Upcoming Events: Find HealthBegins Here


Care Compass Network DSRIP Symposium
June 19 | Ithaca, NY
June 20 | Binghamton, NY

A PPS-wide community event for all who are interested in the challenges and opportunities to improve care and the social determinants of health.

UCLA/Johnson & Johnson Health Care Executive Program
June 25 | Los Angeles

Executives of community health centers participate in an 11-day, intensive management development program at the UCLA Anderson School of Management.
 

Presenting powerful upstream results at an upcoming conference? Nominate yourself to be featured as a HealthBegins Upstreamist in Action at info@healthbegins.org.

Upstream Opportunities:

From Moving Health Care Upstream:

A New Initiative on Population Health Integrator Networks, Funded by the Kresge Foundation

In November 2018, the Kresge Foundation made a two-year grant to Nemours to update its work on population health integrators, with a specific focus on how hospitals and health systems joincatalyze, and sustain the work of population health integrator networks.

For more information, please contact Bilal Taylor (bilal.taylor@nemours.org), Program & Policy Analyst with the Nemours National Office of Policy & Prevention.

If you have fellowships, events, or other opportunities you’d like us to share, please email us at info@healthbegins.org.

Upstream News

Curated highlights of happenings affecting upstream care. Links are not endorsements.
 

Harnessing Digital Information to Improve Population Health
Harvard Business Review

A Secret to Better Health Care
The New York Times

Understanding Provider Screening for Social Determinants of Health
PatientEngagementHIT.com

AmeriHealth Caritas: Greater Acceptance of Mental Health Issues Driving Social Programs
FierceHealthcare

Infants Exposed To Homelessness: Health, Health Care Use, And Health Spending From Birth To Age Six
Health Affairs

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