Let Communities Show the Way

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Presentation transcript:

Let Communities Show the Way Investing in Health: Let Communities Show the Way Building Healthy Communities Federal Reserve Bank of Cleveland October 23, 2014 Rick Brush HICCup.co

What’s the return on $2.9 trillion? What matters to health Health Context & Behaviors (90%) Health Care (10%) S. A. Schroeder “We Can Do Better – Improving the Health of the American People,” New England Journal of Medicine, 357 (2007): 1221-28.

What’s the return on $2.9 trillion? What matters to health Where we spend Prevention (3%) Health Context & Behaviors (90%) Health Care (97%) Health Care (10%) S. A. Schroeder “We Can Do Better – Improving the Health of the American People,” New England Journal of Medicine, 357 (2007): 1221-28. Centers for Medicare and Medicaid Services, “National Health Expenditures” Table 1, (Washington, DC: CMS, Office of the Actuary, National Health Statistics Group, 2012).

What’s the return on $2.9 trillion? What matters to health Where we spend What we get (outcomes:  better,  worse) Health Context & Behaviors (90%) Health Care (10%) (97%) (3%) Prevention  Late Stage Interventions Infant Mortality Life Expectancy at Birth Diabetes Obesity Heart Disease COPD Disability United States compared to 16 "peer" countries, National Research Council, “US Health in International Perspective: Shorter Lives, Poorer Health” (Washington, DC: National Academies Press, 2013). S. A. Schroeder “We Can Do Better – Improving the Health of the American People,” New England Journal of Medicine, 357 (2007): 1221-28. Centers for Medicare and Medicaid Services, “National Health Expenditures” Table 1, (Washington, DC: CMS, Office of the Actuary, National Health Statistics Group, 2012).

really What matters to health?

Health-impact investing

An opportunity? October 19, 2014 http://www.theatlantic.com/health/archive/2014/10/getting-private-investors-to-fund-public-health-projects/381628/

Health-impact investing: Childhood asthma in Fresno CA 16,000 children (potential) health, ER 30%, IP 50% $1K-$5K (estimated net savings PPPY) grant funding for 200 children investors for scale up Health- impact investing 2014 2015 2016 2017 2018 RCT using insurance claims data Home-based education & environmental remediation Validated by third-party actuary

Health-impact investing at a community level

42 communities applied

42 communities applied  4 in Ohio Athens County Marion Tuscarawas County Union County

Wellville Five + Greater Wellville network Clatsop County, Oregon Niagara Falls, New York Greater Muskegon, Michigan Lake County, California Spartanburg, South Carolina

Let communities show the way Clatsop County, Oregon The community is the startup – and the product is health. Niagara Falls, New York Greater Muskegon, Michigan Lake County, California Spartanburg, South Carolina

Health Capital Market community-led (re)investment portfolio of investable solutions “capital stacks” financing + + social/cultural community conditions new health system self-management

Philanthropy/public funding Health Capital Market Health system paid for health new insurance/reinsurance new HC payment/delivery impact investing health trust/fund philanthropy policy change public sector $/incentives debt financing community benefit new business models sponsorships/in-kind micro/crowdfunding innovation fund health credit exchange Investment capital Philanthropy/public funding

rick@hiccup.co HICCup.co @WayToWellville @HICCup_co Get involved rick@hiccup.co HICCup.co @WayToWellville @HICCup_co collectivehealth.net @collectivehlth