Applying a Health Lens to Business Practices, Policies, and Investments Workshop Summary (2016) / Chapter Skim
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2 Increasing Private-Sector Investment in the Nonmedical Determinants of Health
2 Increasing Private-Sector Investment in the Nonmedical Determinants of Health
Pages 5-14
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From page 5... ...
Although it is understood that affecting the social determinants of health through community interventions reduces the likelihood of downstream medical care, investing in such interventions involves risks, he noted. The key to involving the private sector is to find ways to mitigate those risks, and to demonstrate the benefits to businesses of investing in interventions upstream that can prevent or reduce the need to invest in expensive remediation downstream.
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From page 6... ...
It is not just the downstream cost savings that may or may not actually accrue to the coalition of beneficiaries, but what the outcome is worth, such as the value of having a neighborhood of concentrated poverty that does not suffer from lead poisoning. STRATEGIES TO LEVERAGE CORPORATE GIVING Galloway described a context-focused approach to corporate philanthropy that leverages the existing business of the corporation, and supports the long-term goals and profitability of that business (Porter and Kramer, 2002)
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From page 7... ...
Impact investors expect both a social return and a financial return, as these enterprises are sustainable and do generate cash flow. PAY FOR SUCCESS CONTRACTING The two main elements of pay for success1 are a performance-based contract and bridge financing.
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From page 8... ...
. The financing terms of these investments vary significantly depending on the context, including the difficulty of achieving success, the track record of the service provider, and the length of the contract.
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From page 9... ...
Children were given the Peabody Picture Vocabulary Test to predict how many were very likely to need special education due to an initial learning disadvantage, and those children who tested two standard deviations below the mean were assigned to the pay for success payment group. To provide early childhood education to all 600 children (not just those likely to need special education)
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From page 10... ...
The projects have been relatively limited in scope, targeting prison avoidance, special education, chronic homelessness, and foster care avoidance for children born to homeless mothers. There is, however, support in the United States for the pay for success concept.
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From page 11... ...
Baxter added that the San Francisco Federal Reserve, Kaiser Permanente, and others have been discussing how to combine the power of the CRA requirements for banks and the community benefit requirements for nonprofit hospitals around common needs/common assessments. He noted that it would be more effective to bring both to bear on a particular problem than to have them operating separately when the same determinants are at play for both.
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From page 12... ...
He suggested that pay for success contracts could be used for neighborhood-scale comprehensive interventions in a master contracting sense. For example, New York City could enter into a pay for success contract with a large-scale nonprofit such as the Harlem Children's Zone on a set of outcomes.
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From page 13... ...
There are real opportunities for quasi-public/quasi-private entities to enter into pay for success contracts, he noted. He mentioned the coordinated care models that are coming out of the implementation of the Patient Protection and Affordable Care Act (ACA)
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From page 14... ...
This means not just the downstream cost savings that may or may not actually accrue to the coalition of beneficiaries but also what the outcome is worth (e.g., the value of having a neighborhood of concentrated poverty that does not suffer from lead poisoning, or the value of a neighborhood that does not have a significant portion of low-income children with unnecessary asthma emergencies)
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