Drivers of health in action: shining a spotlight on CommunityHealth

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Jun 9, 2022

In our latest research, You are what you treat: Transforming the health care business model so companies—and people—thrive, we set out to discover what makes health care organizations capable of successfully addressing the drivers of health (DOH). In short, the answer lies in their business models. 

In order to better understand what allowed certain organizations to succeed in their DOH efforts, we interviewed leaders that are successfully addressing DOH in their work, breaking free from the sick care business models of the past and building new models to create health. One such leader, CommunityHealth, provided pivotal insights into what effective business models can look like. 

CommunityHealth is a patient-centered medical home located in Chicago, Illinois, providing free medical care and wraparound services to uninsured and underinsured adults in the city. Services include: 

  • Behavioral health, 
  • An on-site pharmacy and prescription access, 
  • Health education, 
  • DOH screening, and 
  • Connections to organizations that can meet the patient’s DOH needs. 

Their goal is to provide a space where uninsured patients, who more frequently go without medical care, can access consistent, quality health care. What began in 1993 as a small group of volunteers providing care a few days a week has since grown into the largest volunteer-run health clinic in the United States. 

The key to CommunityHealth’s success lies in their business model. Let’s look at each of the business model components to highlight a few of these keys to success. 

Value Proposition

CommunityHealth has a clear value proposition: delivering free, quality health care to those who need it most, by trusted community members. They emphasize care access, health outcomes, and consumer experience in their approach, and they take a holistic look at what it means to be healthy. In the process of addressing the lack of care for uninsured community members, CommunityHealth developed an approach to address the drivers of health, which are critical to improving health outcomes.

Resources 

In order to deliver on their value proposition, CommunityHealth focuses on three main pillars: volunteerism, philanthropy, and partnerships. Their volunteerism is one of their biggest resources; CommunityHealth boasts a network of over 1000 volunteers providing their services free of charge. They’ve also established a wide range of partnerships. Partners include medical schools that provide students to help care for patients, pharmacies and pharmaceutical companies to provide free on-site prescriptions, community organizations addressing patient social needs like food security, electronic medical record platforms such as AthenaHealth and the community connection platform NowPow to support operations. 

Their innovative culture, characterized as one where people are encouraged and willing to pivot and change direction when needed, is also critical to their ability to improve patient health. An example of this culture arose during the COVID-19 pandemic. Overnight, CommunityHealth had to transition their in-person appointments to telehealth, with 90% of appointments happening over the phone. The switch helped to identify key patient needs. As a result of the switch, the no-show rate for appointments dropped when patients no longer had to worry about transportation. This consumer insight led some services to remain virtual only, freeing up physical exam rooms for services such as physical therapy, which are optimized with an in-person visit. 

Another example of their ability to iterate their approach based on consumer insight was the development of their telehealth microsite. This initiative began as a result of redefining what it meant to provide patient-centered care. Realizing that access is not just having appointments available, but also accommodating social needs that can prevent a patient from seeking care, CommunityHealth set up a telehealth microsite inside of a community center utilized by its patients and those it was seeking to reach. The center provides a central access point for multiple DOH needs, such as food access and childcare, and now patients can use on-site laptops to virtually connect with CommunityHealth about medical concerns. 

Processes 

Collecting patient feedback is a critical process to inform their innovations. To hear directly from patients, CommunityHealth uses simple text surveys immediately after appointments to ask patients about their experience. 

In-depth patient appointments are another key process that allows them to meet patient needs. Each appointment is 30-45 minutes, and providers see a maximum of ten patients per day. All patients are universally screened for DOH needs. The understanding this screening provides enables clinicians to see patients as whole people, rather than focusing solely on their medical needs. 

Profit Formula/Priorities 

All of CommunityHealth’s revenue is from philanthropy or in-kind donations. And CommunityHealth pursues funders whose visions and incentives are aligned to theirs. One example of this is their Health First Collaborative grant, which aligns with CommunityHealth’s desire to constantly innovate and test the waters of new ways to provide high quality care. To CommunityHealth, success is measured by what innovations they tested and what they learned from those innovations.

To quantify the impact on health care costs, CommunityHealth tracks cost savings as part of their partnership with a health system. When patients without a medical home present to the ER or become an inpatient, the health system refers patients to CommunityHealth.. Together with the health system, CommunityHealth tracks whether that patient presents again to the ER or is admitted again. Tracking the avoided costs of their 0% readmission achievement over the past five years, CommunityHealth saves the health system between $350,000-$500,000 per year. Part of these savings are donated back to CommunityHealth to run their services. 

CommunityHealth’s founder knew that in order to better address the whole health of underserved patients, they needed to approach health care differently. The result of that vision is a business model that values innovation and appropriate risk taking to seek better solutions to care problems, prioritizes strategic partnerships, and views patients as whole people. Their model provides a much needed service to the community, and is just one example of how to build a business model that can successfully address the drivers of health.

Jessica is a research associate at the Clayton Christensen Institute for Disruptive Innovation, where she focuses on business model innovation in healthcare, including new approaches to population health management and person-centered care delivery.