How Regional Health Improvement Collaboratives Are Financed
All of the work done by Regional Health Improvement Collaboratives is challenging, but one of the most challenging tasks Collaboratives face is obtaining adequate funding to support their work. Collaboratives typically obtain their funding from three types of sources:
- Membership "Dues." Most Regional Health Improvement Collaboratives rely on annual financial contributions from the healthcare stakeholders in the community. Unlike dues payments made to many professional associations, however, these payments will usually be treated as tax-deductible contributions because of the charitable tax status of the Collaborative. These types of payments are critical because they provide flexible funding to cover the operating costs of the Collaborative (rather than being restricted to particular programs).
- 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 or others for which they charge a fee. For example, some Collaboratives provide consulting services or coaching to healthcare providers to help them improve their quality of care, or offer courses in quality improvement for the employees of healthcare providers.
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, has 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 is 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 exponentially increasing demands that will be placed on them 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. 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.