Advancing Resilience & Community Health (ARCH)

The Advancing Resilience and Community Health (ARCH) project was designed to help burgeoning relationships between healthcare institutions (payors and hospital systems) and community-based organizations (CBOs) get off the ground successfully and at a scale that could make a difference. NFF partnered with three networks – EngageWell IPA (New York), Metropolitan Alliance of Connected Communities (Minnesota), and Thomas Jefferson Area Coalition for the Homeless (Virginia) – to explore what it takes for networks of CBOs to come together and partner with healthcare. 

On this page you'll find:

• ARCH Networks' Response to COVID-19
• About ARCH
• What We're Learned
• ARCH Voices: Who Was Involved
• A Look at What Brought Three Networks Together
• Resources

EngageWell IPA, Metropolitan Alliance of Connected Communities (MACC), and Thomas Jefferson Area Coalition for the Homeless (TJACH) – coalesced their resources, knowledge, and power to meet the imminent needs of their communities and members during the COVID-19 crisis. As individual community-based organizations continued to conduct mission-critical work on the ground, networks played a salient and valuable role to members during this unprecedented time by providing flexible resources, filling critical capacity gaps, fundraising, and advocating on behalf of members.

Here are some ways that our networks contributed to solutions for their members and communities:

EngageWell IPA

• EngageWell submitted seven grant applications on behalf of member agencies to support a network-wide telehealth platform, patient/provider telehealth equipment and connectivity, the development of a network-wide training program, and other agency-specific needs. Five grants were awarded, totaling $1.4 million, with another $750,000 under consideration. 
• The network also managed bulk orders of PPE for providers within the network and coordinated the delivery of food, hygiene supplies, and medication to at-risk clients.

MACC

• MACC led advocacy efforts within the network, including a letter to state legislators with funding guidance around contract terms, requesting that government keep contract commitments regardless of an organization’s ability to provide the same level of service during the COVID-19 crisis.
• The network hosted a virtual summit for members, alongside lobbyists and lawyers, to inform members how COVID-19 impacts their contracts and to solicit feedback on member experiences.
• MACC also provided critical member support through their shared service lines on HR implications, billing for telehealth/telemedicine services, plus financial projections and reforecasts during this time of change.

TJACH 

• TJACH identified funding from the Emergency Operation Center for rooms at a local hotel where people experiencing homelessness can stay and self-isolate from one another. TJACH also paid directly for an additional floor of hotel rooms so that people who test positive for COVID-19 have a safe place to land after being discharged from the hospital.  
• The network coordinated with UVA medical students to conduct daily meal delivery and check-ins for these individuals.
• TJACH also developed processes for people who test positive within the homeless community, including organizing required nursing staff, housing workers, and security.

A safe, clean place to live. Neighborhoods and parks where people can walk and play. A job that pays a living wage. Nutritious food on the table. Along with good medical care, these are some of the many factors that help make us healthy. Providers and payors in the healthcare system increasingly recognize that where we work, play, and live – what are called the “social determinants of health”– are as important to their patients’ health as good medical care. Nonprofit community-based organizations (CBOs) have long focused on addressing these social determinants of health (SDOH). So, how can healthcare organizations and CBOs work together to better care for their clients?

What We Hoped To Achieve 

We set out to support networks of CBOs – nonprofits that had already come together to address multiple needs – that were looking to collectively contract with often-larger healthcare institutions. Some of the questions we set out to investigate include:

• How are CBOs working together collaboratively to build agreements with healthcare?
• What are new payment models for this integrated work?
• What do fair contracts look like?
• How can CBOs prepare for an influx of new client referrals from their healthcare partners?
• How do we structure contracts to focus on long-term patient well-being?

Our capstone report highlights themes and lessons learned that we hope will inform new approaches to advancing community health, including:

• Contracts have more disadvantages than benefits
• Networks redefined success by prioritizing communities over contracts
• Addressing health equity means centering racial equity
• It’s time to invest in community-led solutions

Insights from ARCH:

• ARCH: Lessons Learned from Partnerships Between Networks of Community-Based Organizations and Healthcare Organizations, with a closer look at the disadvantages of contracts, why centering communities is so important, and the role of racial equity in pursuing better health outcomes 
• Contract and Partnership Overview, a closer look at the types of contracts and partnership opportunities each ARCH network explored and what we learned from the experience
• Achieving Health Equity: Community-Led Alternatives to Healthcare-CBO Partnerships, blog by NFF's Deirdre Flynn
• Perspectives from the ARCH Project: How do leaders from healthcare institutions view social determinants of health? shares findings from interviews with seven leaders of five healthcare institutions that participated in the ARCH project, authored by Jean-Baptiste and Alaya Martin of Mathematica with reflections from NFF
• Four Ways to Overcome Partnership Hurdles and Address Social Determinants of Health, a blog co-authored by Juliette Price, Chief Solutions Officer for Helgerson Solutions Group, and NFF's Deirdre Flynn
• Strategic Cost Allocation offers core concepts and guiding questions to help nonprofit leaders understand costs and explore the connection between costs and mission goals
• A Look at Data Systems explores themes and considerations about data sharing and integration from EngageWell IPA, MACC, and TJACH  
• Blog Series: Setting Strategic Priorities with EngageWell, MACC, and TJACH
• The Road Ahead charts how each network is working toward its goals
• NFF's Deirdre Flynn wrote a blog about Questions Networks Are Asking Themselves to Find Their Why featuring a brief video of network leaders and members discussing the value of networks
• NFF’s Lisa Thirer authored an article for Grantmakers In Health titled, “Who Will Pay for Partnerships that Address Social Determinants of Health?”
• The Snapshot of CBO Networks shows the different dimensions of how CBOs come together – whether place-based, issue-based, or other – and how these dimensions combine in unique ways for each network

Below are three short videos featuring interviews from leaders and members of three networks – EngageWell IPA (New York), Metropolitan Alliance of Connected Communities (Minnesota), and Thomas Jefferson Area Coalition for the Homeless (Virginia) – about what it’s like to come together around a shared vision for better health equity for people in our communities. 

EngageWell Transcript

MACC Transcript

TJACH Transcript

Support for Advancing Resilience & Community Health was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.