Culture of Health Blog

COVID-19 has been devastating for children and families.

Millions of parents and caregivers lost jobs and income, hindering their ability to put food on the table. School closures, remote learning, and limited-to-no access to child care has weighed heavily on many, especially those with lower incomes working essential jobs everywhere from grocery stores to nursing homes. The pandemic has also exacerbated existing housing challenges, from high rental costs to an ongoing eviction crisis.

In spite of these challenges, our colleague Jennifer Ng'andu recently noted that families are resilient and hopeful. Because the pandemic weighs so heavily on working families, a key piece of inclusive recovery is ensuring that caregivers and their children have the support they need to thrive.

As researchers, our job is to glean lessons from the data and understand what will help communities recover. Since 2016, we’ve been following 29 diverse communities to understand how they approach health, well-being, and equity. When the pandemic hit, we pivoted to focus on nine of these communities. Doing so allowed us to closely follow COVID-19’s impact and understand local response and recovery efforts.

I believe a unique opportunity for a philanthropic organization is to explore the big ideas. We have a freedom that few others have to really experiment and innovate. Even to take big risks in our grant making sometimes. Often, the rewards are insights – they offer a glimpse of how our nation can address some of the most pressing challenges facing our society.  Aligning Forces for Quality is an example of this philosophy in action.”  —Risa Lavizzo-Mourey, MD, MBA, president and CEO of the Robert Wood Johnson Foundation 

In 2006, the Robert Wood Johnson Foundation (RWJF) launched a bold, ten year experiment that became one of its largest philanthropic investments—the Aligning Forces for Quality (AF4Q) initiative which sought to lift the overall quality, equality, and value of health care in 16 communities across the country.

In each AF4Q community, a regional alliance of doctors, patients, consumers, insurers, and employers worked collaboratively to transform their local health care system. Lessons from these transformations were then used to develop national models for reform. Alliances were tasked with addressing five “forces” to enhance quality while reducing costs:

• performance measurement and reporting
• quality improvement
• engaging consumers in their health and health care
• reducing health care disparities
  
• reforming payment

My boss and mentor Andy Hyman was the kind of visionary leader who instilled a deep sense of hope in everyone he came into contact with. He inspired in us a feeling that anything was possible. It’s this kind of unwavering hope that is needed when pursuing seemingly insurmountable goals—like the goal of ensuring that everyone in America has access to affordable, quality health care coverage.

Andy led the Robert Wood Johnson Foundation’s (RWJF) work on health insurance coverage from 2006 until shortly before his untimely death in 2015. One of the things I vividly remember was his deep conviction—even when progress seemed elusive—that we could make major strides toward improving coverage for those who needed it the most. 

Among his many wonderful qualities, Andy had keen political foresight that revealed itself when I started working with him back in 2006. He predicted a window to put the spotlight on health reform in 2008, regardless of who was elected president. In preparation, he led our team in building evidence to make the case for health reform and in bolstering the capacity of community of advocates nationwide who could work on state-level reform. Once the Affordable Care Act (ACA) was enacted, Andy worked tirelessly to help implement it in the states.

 Forbes is known for its lists – America’s richest people, most expensive zip codes, most promising companies and more. This year, for the first time in its 94-year history, Forbes released a new list – the top 30 social entrepreneurs. We’re proud to announce that Pioneer grantees made the list – twice!

Jay Coen Gilbert, Bart Houlahan and Andrew Kassoy made the list for B Lab, a nonprofit that certifies businesses as “B Corporations”—companies that adopt a legal structure requiring them to create value for a broad set of stakeholders—employees, communities and the environment–not just their shareholders.  Their hope is that certified “B Corps” will flourish by attracting consumers who are looking to support businesses that align with their values and helping investors to drive capital to higher-impact investments with greater social responsibility, as well as financial returns.  To be certified, companies must adopt the legal structure and pass an annual B Impact Assessment. Under their Pioneer-funded grant, B Lab will develop the first set of criteria to assess a corporation’s performance in areas of employee and community health and safety to be included in the annual assessment.

Sara Horowitz is listed for founding Freelancers Union, which provides affordable health insurance to freelancers, consultants and temps who don’t have access to employer coverage. Her grant from Pioneer enables the Freelancer's Union to expand its group purchasing health-benefits program from New York into New Jersey and Georgia.  A previous grant established the for-profit Freelancers Insurance Company to design a health plan model for freelancers in New York state that combines catastrophic insurance coverage with coverage for prevention and wellness services.

RWJF’s Vulnerable Populations Portfolio is also excited to see two grantees on the list. Jill Vialet made the list for founding Playworks, which improves the health and well-being of children by increasing opportunities for physical activity and safe, meaningful play. Playworks sends trained, full-time coaches to low-income, urban schools, where they transform recess and play into a positive experience that helps kids and teachers get the most out of every learning opportunity throughout the school day. Rebecca Onie is included for co-founding Health Leads, which mobilizes undergraduate volunteers to help patients fill “prescriptions” shared during provider visits for basic resources needed to be healthy, like food, heating assistance, child care or housing. Health Leads is one of many promising models addressing social needs through the health care system.

As team director of the Pioneer Portfolio, I’m thrilled to see our grantees singled out as innovative entrepreneurs. These innovators represent the kind of leadership and ingenuity that can help us tackle the tough health and health care problems we face in the U.S. Check out the story and don’t forget to congratulate Jill Vialet (@jillvialet), Rebecca Onie (@rebeccaonie), Sara (@Sara_Horowitz) and the B Lab crew (@BCorporation) on Twitter using the #Impact30 hashtag.

This commentary originally appeared on the RWJF Pioneering Ideas blog.