Since the national call to address health inequities hit a fever pitch last year, we've been eagerly monitoring whether this momentum would translate to fundamental change—or just remain surface level. For us, the biggest indicator is in how money changes hands. Would the confluence of Covid-19 inequities and protests against police brutality be enough to alter how the industry does business?
Access the health equity resource page
Apparently, not yet. There's still a limited shift to value-based payment, insufficient cross-industry financial incentives for advancing equity, and a lack of penalties for poor performance. These are the very changes to our business models that would require us to make progress toward equity. In the absence of top-down change from policymakers, the onus rests on the shoulders of health care leaders to use whatever leverage they have to push the industry toward this structural change. But that monumental task is going to require significant alignment with stakeholders who we're not used to viewing as partners.
The health care leaders we work with will be the first to tell you that they don't have the competencies to tackle a problem like equity on their own. But they've also been relatively limited in who they've traditionally partnered with to advance health equity. Primarily, leaders look to community-based organizations (CBOs), who bring essential capabilities like building community trust and delivering social services. But leaders still seem reticent to look within our own industry for partnerships—especially when it comes to direct competitors.
That's a major missed opportunity. It might feel uncomfortable, but these types of partnerships can amplify our impact. In addition to the potential to shift incentive structures across the industry, the comparative advantages of one sector can fill gaps in another. Even the best CBOs can't fill these gaps—they don't have the scale, reach, or resources that exist within our own industry. Cross-industry partnerships are the only way we can navigate traditional inefficiencies while shifting to business models that incentivize this work.
We can push each other to do better, but only if we approach partners in the right way. And while the focus of this piece is cross-industry partnerships, each of these tactics can help bolster your working relationships with CBOs, too.
1. Get your own house in order first
To build credibility in the community and ready yourself to be a good cross-industry partner, organizations must establish a health equity "infrastructure" that is durable (e.g., can withstand departures from motivated individuals). This includes:
2. Select the right partners who align with your goals and can help you fill gaps
Look for partners who have the same vision of what long-term success looks like. Ideally, that vision is backed up by similar incentives and business models. If not, partners must be willing to work towards evolving their business models to align on shared goals and incentives—even with previous competitors. Partners must agree to:
3. Determine how you and your partners can hold each other accountable for progress
It can be difficult to commit to the vulnerability and transparency that advancing equity requires. But we have to own our mistakes, admit when we need help, and listen to feedback if we want others to do the same. We at Advisory Board hope to model this by acknowledging that this piece only scratches the surface on how cross-industry stakeholders can partner to hold each other accountable for change. As you make progress in this space, don't hesitate to reach out and tell us what you've tried. Email Darby Sullivan at firstname.lastname@example.org.
Diversity, equity and inclusion (DEI) is increasingly a priority for health care organizations. Leaders must integrate DEI into the missions and strategies of their organizations. Let us help put the right building blocks in place.
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