Policy Leadership for Health Care Transformation: Formalizing our Commitment to Communities

A growing number of hospital and health system leaders now support a shift in financial incentives, which has the potential to lead to a transformation within health care. In this environment of change, uncertainty, and high expectations, there are many notable projects supported by hospitals and health systems across the country that highlight successes. But at the same time, there is a need to move beyond small-scale projects and innovations to create structures and functions that formalize the commitment to change and incentivize desired behaviors at the individual, departmental, and institutional level. Taking these critically important steps will help build the momentum needed to scale innovations and generalize practices.

Policy Leadership for Health Care Transformation is the result of a year-long collaborative project between PHI, on behalf of the Alignment of Governance and Leadership in Healthcare (AGLH) initiative, and Moving Health Care Upstream (MHCU) to identify specific institutional policies and civic engagement strategies that can be used by hospitals and health systems to codify, sustain, and scale practices that address the social determinants of health in local communities.

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With input from 18 hospitals and health systems that were early pioneers in the upstream movement, as well as guidance from an advisory board of 13 nationally recognized subject matter experts, the collaboration produced a paper that:

• Summarizes the goals of the initiative and the methodology used to create the organizing framework and recommendations;
• Presents an action-oriented organizing framework of Institutional Policy Strategies and Civic Engagement Strategies, supported by examples from participating hospitals and health systems; and
• Includes a compendium of sample policy documents, generously shared by participating hospital and health systems.

The diversity of the U.S. health system, the public policy environment, and the communities served mean that there are a variety of possible paths to achieve transformation. Organizations are all in different stages of the transformation process and may be advanced in some areas, while just getting started in others. Hospitals, health systems, and diverse stakeholders can take action at many levels to advance this work, but it is critically important to give equal attention to how these commitments are formalized within organizations and support robust civic engagement in communities.

The concrete, action-oriented strategies and examples within the paper are intended to inform and accelerate upstream work of others in the field.

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Supplementary Materials

Executive Summary

Hospital/Health System Self-Assessment Tool

Alignment of Governance and Leadership in Healthcare Program Logic Model