AIHC: What Are We Learning, Part 2

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Accelerating Investments for Healthy Communities was designed to help health institutions that were already investing in the upstream determinants of health advance and deepen their investments in affordable housing. The initiative was based on the principle that helping leading edge hospitals and health systems take their work to the next level—honing strategies, identifying and engaging with partners, leveraging additional sources of funds, and considering impact targets and metrics – would result not only in healthier and more equitable communities, but also in important lessons that would be useful to other health systems.

As we approach the end of Phase 1, we’ve seen remarkable engagement and progress from the participating institutions. Here are some observations:

The Need for Interdisciplinary Perspectives: Health systems often ask how they should staff their work on social determinants of health. One lesson we have learned from AIHC is the value of bringing together teams from across departments to think strategically about investments in the community. Our cohort included plan executives, CFOs and treasurers, leaders of mission and community health as well as good representation from community benefit, strategy, facilities and innovation departments. Combining clinical, financial, real estate and planning expertise with an understanding of the community and its needs sparked creativity and took conversations into new territory. Having a standing group like this responsible for community investment could be an important part of the recipe for success.

Harnessing Diverse Assets: Throughout the program, health systems expanded the array of assets they were considering using for their upstream investments. In addition to community benefit dollars, sources of investment the health systems mentioned included Determination of Need funds, endowments, operating funds, external donations, cash reserves, capital gains from for-profit affiliates, and excess land. Continuing to help the systems tap these varied resources and think about leverage appropriately will contribute to scaling deployment of capital in the community investment system.

Engaging Partners: Several of the health systems were already collaborating or in conversation with developers, CDFIs, and CDCs. However, most of the systems had questions about how to navigate these relationships in ways that would maximize the health and community impact of their engagement. Exercises on “gives and gets”, understanding the business and mission factors driving decision making, helped the institutions get a better sense for how to engage with partners they were already working with, and get a broader view of the ecosystem of partners they could potentially tap.

Measuring Impact: Measuring the health and financial impact of investments was a hot topic among participants. Thinking about how to prioritize potential investments and set impact thresholds for the investments they were considering was also of great interest. Several systems realized their health plan colleagues could contribute a great deal to understanding the potential impact of investments. A discussion of HNEF’s neighborhood and project level screens helped clarify how the health systems might communicate their priorities to their partners, causing several of the systems to rethink the targets and reports they planned to request.

Next week we will conclude Phase I of AIHC with a convening in Princeton, NJ. Stay tuned for news about the systems’ progress and about the next phase of our work with these pioneers.

(Photo credit: Katie Grace Deane)

Transforming investment in communities

The Center for Community Investment at the Lincoln Institute of Land Policy is supported by the Robert Wood Johnson Foundation, The Kresge Foundation, the John D. and Catherine T. MacArthur Foundation, and the Surdna Foundation.

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