As the calendar turned over from 2019 to 2020, it not only signaled the start of a new decade — it marked the ten-year anniversary of Collaborative Consulting. I thought this would be the perfect time to reflect on how healthcare and social care have changed, the role we’ve played, and what it means for how we’ll work with you in the future. 

A LOOK BACK 

When the Affordable Care Act was signed into law in 2010, one thing was clear to me: The future of healthcare would require more cross-sector collaboration. And because I’ve always been attracted to exploring what’s possible and discovering potential in new spaces, I founded Collaborative Consulting. 

Since then, we’ve helped all sorts of entities within the health and social care sectors form a wide range of alliances and partnerships. Our work with community-based organizations (CBOs) has enabled them to fine-tune their offering to healthcare — what services they could provide, at what price, and how they might integrate seamlessly with medical services. We’ve now worked with more than 200 CBOs across the US, many of which have gone on to develop a portfolio of partnerships with healthcare organizations. Some have even taken on leadership roles in major healthcare initiatives such as CMS’ accountable health communities and Medicaid waiver programs. 

We’ve always been clear about how we wanted to help advance healthcare reform in this country. Rather than just provide external expertise, we’ve sought to activate and cultivate the internal capabilities of the organizations we’ve worked with. Our view was — and remains — that while partnering with healthcare is an immediate business opportunity for CBOs, the organizational capacity required to establish those partnerships will be just as useful for an organization’s broader growth. In other words, becoming expert in partnering with healthcare confers wider benefits across the organization. 

It would be wrong of me, however, to look back at the last ten years and only see sunshine. Building new capabilities and organizational capacity is about change, and change is never easy. For example, we’ve worked with CBOs to replace long-term leadership, bring in new talent, and instill a culture of business development that hasn’t always sat well with staff. While decisions like these are tough, we believe they are a necessary part of equipping CBOs to thrive in a rapidly evolving environment. 

And healthcare is certainly a rapidly evolving environment. There’s growing acceptance that our health is influenced by more than the availability and quality of care. Most of the factors — such as our social and physical environments — are non-medical and complex. The emerging definition of healthcare involves attending to needs like poor nutrition, lack of transportation, and social isolation. Federal and state healthcare policies, and initiatives like Medicaid waiver programs and the expansion of Medicare Advantage benefits, are catalyzing medical-social integration, broadening coordinated care environments, and changing how care is delivered and paid for. 

These changes present new opportunities for organizations that deliver social services. And this brings me to my thoughts about what the coming decade may hold for you — and how we can help. 

A LOOK AHEAD 

You don’t need a crystal ball to predict that cross-sector partnerships will become even more important in the 2020s. At Collaborative Consulting, we’re already seeing more CBOs get serious about working with healthcare by capitalizing on their social service delivery and community relationship-building expertise. We’re also seeing healthcare organizations get more serious about working with CBOs. As they continue to focus on creating better outcomes, the ability to identify and address social risk factors and needs takes center stage. Like with many newly disrupted industries, we’re seeing a new breed of intermediaries emerge to help connect the health and social care sectors through technology referral platforms. 

On the face of it, these are positive shifts, a movement that could lead to better, more integrated and person-centered care. But there are challenges too. Expectations for service quality and outcomes are rising. Competition among CBOs — and between CBOs and for-profit companies — is heating up. Ill-prepared organizations risk failing to take advantage of the opportunities coming out of healthcare on the one hand, or on the other becoming so focused on meeting healthcare’s needs that they lose sight of what’s best for their own organization. 

Shifts like these make it clear to me that the reason why I founded Collaborative Consulting in 2010 is the way we will help organizations like yours tap into your potential in 2020 and beyond. 

A STEP FORWARD 

Given the diversity of healthcare and social sector organizations we’ve worked with over the past ten years, it’s possible for us to see patterns that separate those that adapt and excel from those who merely maintain in the face of change. This, in turn, has led us to a keen understanding of the capabilities CBO leaders need to understand, possess, deploy and optimize in order to grow their organizations and deliver better results during a new decade in which cross-sector partnerships will be even more central to success. 

Broadly, we see four important areas to advance effective cross-sector partnering in 2020.

Designing Partnerships with More Rigor 

High potential long-term partnerships require robust early-stage strategy, planning, design and development. No one wants to see pilot programs dry up and go away because there wasn’t enough attention paid at the beginning to developing the right proposition, defining the suite of services, putting a realistic measurement plan in place, and determining the right financial mechanism that achieves return for both partners. Yet in many cases they do. By spending more time and energy building the fundamentals (relational, operational, and financial) and designing integrated programs on the front end, you will establish a sturdier foundation for partnerships to sustain and create the right conditions for better results. 

Developing and Growing CBO Networks 

While starting and sustaining long-term partnerships with the healthcare sector is an important avenue for growth, building beneficial alliances with other CBOs will prove a vital strategy for meeting the healthcare industry’s rising demand for high quality non-medical services in the years ahead. We are seeing a variety of network types emerge at local, state and regional levels, prompted by evolving healthcare financing policies, growing interest in non-medical services from healthcare organizations looking to improve their clinical and financial performance, and mission-driven coalitions striving to improve the wellbeing of target populations. All of this equates to more connectivity, collaboration, and competition among CBOs, and between CBOs and for-profit providers. 

Building CBO networks in the coming years will require leaders who understand how to influence a system of cross-sector teams where traditional hierarchy doesn’t exist, how to operationalize standards and processes across multiple organizations, and how to improve data sharing philosophies and technologies between the sectors.           

Deploying and Optimizing New Capabilities 

Clearly, the ability to design, develop and grow partnerships and networks will widen the gap between those that flourish and those that flounder. To succeed, community-based organizations will need to attain and deploy new competencies — deploy being the operative word. Because we’ve always been committed to helping our clients create more capacity and build new skills, we’ve been able to identify critical capability-building areas that, in aggregate, support a framework to further advance health and social care partnerships. For those of you leading CBOs, the framework will help you better understand the capabilities needed for successful partnering with healthcare. And for those leading healthcare organizations, it will help you understand how you need to work with CBOs to ensure partnerships are sustainable. 

I should note here that we’ve designed the framework with customization in mind because each effort aimed at advancing health and social care partnerships is unique. For example, for one recent multi-year project, the framework consisted of five broad domains that were linked to elements of the initiative: Market Knowledge and Foresight, Strategy and Planning, Leadership, Control and Performance Management, and Financial Acumen. Within these domains we assessed 36 specific capabilities necessary for acquiring and sustaining cross-sector partnerships, determining the extent to which the CBO possessed and/or had deployed each in their own organization, and allowing us to identify and address areas for further skill-building. 

Deepening Your Financial Acumen

Of all the competency areas, the financial acumen required to sell social services to healthcare organizations is the most underdeveloped area for many CBOs we’ve helped. Yet, it’s one of the most critical capabilities for creating equitable arrangements, projecting return on investments in social services, and generating solid results for both partners. Strong financial acumen can mean great rewards for all parties in a partnership; weak financial acumen can lead to shortfalls, misguided projections, and unsustainable programs. Many CBOs underestimate the complexity and the importance of this area and have limited experience operating under new kinds of service agreements and healthcare payment mechanisms. Because of this, we’ve doubled down on our efforts to better assess the financial acumen of organizations and provide targeted consultation to organizational leaders so they can enhance these essential competencies. 

In the coming months, our long-time collaborator Victor Tabbush will share observations and techniques for how CBOs can assess and advance their own financial acumen. 

A TIME FOR ACTION 

I’ve always said that Collaborative Consulting is “where ideas evolve into action”. And what was true in 2010 remains true at the start of the 2020s: Action is the key to seizing opportunity, overcoming obstacles and creating a better system of health and healthcare. 

So, I hope that — like us — you’ll take a few moments to reflect on where your organization has been, what it will take to achieve your organization’s objectives, and how you will act on the ideas you have for designing effective partnerships, expanding networks and building the capabilities you’ll need for the decade ahead.