Building a business case for sustainability–why you need one, and why this is the time to get started

March 19, 2020
Marianne Udow-Phillips, Founding Executive Director, Center for Health and Research Transformation (CHRT)

Community based organizations providing important social services–supportive housing, food security, mental health, substance use services and the like–are often challenged to maintain programs over time. Without an ongoing revenue stream, many human service oriented organizations struggle to keep important services available in the community. In this context, when we talk about sustainability, we’re talking about ensuring that organizations that provide effective human services can keep those services going and scale them to magnify their impact.

It’s common for foundations and government entities to fund pilots. But foundations rarely fund programs for more than a few years. How then do community based organizations that have implemented programs–programs with demonstrated results–continue those programs on an ongoing basis? 

America spends a great deal on health care–more than any other country in the world–and in an ideal world, those dollars would support the programs that improve health, regardless of whether those are flu shots, nutritional supplements, counseling sessions, supportive housing, or financial coaching. Unfortunately, that’s not the case. The health financing system we have in this country generally focuses on funding the medical delivery system and not broader services that might actually make a bigger impact on health. 

However, there are signs that the historical approach to funding health care in the U.S. is beginning to change. In 2019, Medicare added a new opportunity for Medicare Advantage plans to pay for services related to the social determinants of health. Medicare’s decision opens the door for new and sustainable funding for organizations providing these needed and evidence-based services. Many private payers follow Medicare’s example, as does Medicaid. So, new opportunities for sustainable funding are definitely on the horizon.

At CHRT, we help clients navigate these realities to achieve sustainability. We help them develop robust evaluation protocols; analyze the data they’ve collected to ascertain the impact in terms of quality, customer experience, and cost; then build a compelling business case for payers. Ultimately, we help clients think about projects objectively, analyze their impact, and demonstrate the value to the payers and providers that have the power to keep them going.