Collaboratives typically obtain their funding from three types of sources:
- Membership “Dues.” Regional Health Improvement Collaboratives rely on annual financial contributions from the healthcare stakeholders in the community. These types of payments are critical because they provide flexible funding to pursue the priorities of the Collaborative (rather than being restricted to particular programs) but even more importantly reflect the commitment and meaningful involvement of local stakeholders.
- Grants. In addition to membership dues, most Regional Health Improvement Collaboratives rely on grants from foundations and government agencies to support their programs. In some cases, Collaboratives may receive unrestricted operating grants from foundations which can be used to fund general operations, particularly in the early years of their existence, but more typically, foundation grants will be restricted to use for specific projects and time-limited activities.
- Fees for Services. Some Regional Health Improvement Collaboratives provide specific services to healthcare providers, employers, state agencies or others for which they charge a fee. For example, some Collaboratives provide technical assistance or coaching to healthcare providers to help them improve their quality of care, or offer reports and analytic support to employers seeking to understand health care trends and costs.
Most Regional Health Improvement Collaboratives lead or participate in federal programs including serving as the Hospital Engagement Network (HEN), Regional Extension Center (REC), Quality Improvement Organization (QIO), Qualified Entity (QE) or partnering in the State Innovation Model (SIM) awards or Medicare Advanced Primary Care Practice (MAPCP) pilots. Despite the key role that Regional Health Improvement Collaboratives can play in ensuring the success of federal healthcare reforms in local communities, there is currently no federal funding program that provides support for the administrative operations of Regional Health Improvement Collaboratives. Although the Department of Health and Human Services (HHS) and the Agency for Healthcare Research and Quality (AHRQ) promoted the creation of multi-stakeholder collaboratives through the Chartered Value Exchange (CVE) program, they do not provide any funding for general operating support of Regional Health Improvement Collaboratives. The Beacon Communities Program, which was established through the Office of the National Coordinator for Health Information Technology at HHS, provided significant funding to a number of communities for multi-stakeholder healthcare improvement activities, but since the funding came through the 2009 American Recovery and Reinvestment Act, it was explicitly a time-limited program.
In the years ahead, it will be critical for Regional Health Improvement Collaboratives to have adequate resources both to maintain their current programs and to address the increasing demands being placed on them and their local members by healthcare reform efforts. Although program-specific funding is desirable, unrestricted funding is essential to support the core operations of the Collaborative and to provide the flexibility to pursue new opportunities in innovative ways- the true strength of the Collaborative. In addition, if Collaboratives are to remain truly multi-stakeholder, community-based organizations, those resources will need to come from all stakeholders in their communities, as well as from state and federal government sources. This is why obtaining funding to support the work of Regional Health Improvement Collaboratives is one of the top advocacy priorities for NRHI members.