Shift helps launch guidance document for Health Systems Anchor Strategies

Healthcare anchor institutions play a crucial role in ensuring the well-being of communities and promoting equitable health outcomes. To achieve their goals for equity and resilience, it is imperative for institutions to deepen their engagement with community partners and incorporate community voices to foster shared power dynamics. By actively engaging community partners, such as grassroot organizations, community leaders and community members, healthcare anchor institutions can develop equitable strategies and investments that address the unmet needs of the communities -- defined by the communities themselves. Healthcare without Harm recently launched the Anchored by health care: Strategies for health systems report, for which we were a key contributor.

Shift has partnered with the Anchors in Resilient Communities effort, a partnership between Healthcare Without Harm and Emerald Cities Collaborative, for over two years. Our partnership focuses on deepening anchor investments in health, wealth and climate initiatives in the San Francisco Bay Area, with specific attention to building test cases and opportunities for community co-design of anchor initiatives. We are excited to share this resource with our network that helps seed similar efforts nationwide.

Key recommendations from this report include:

• Deepen systemic and accountable anchor engagement
• Co-create a definition of success and share it
• Increase diversity in planning beyond community partners
• Build capacity and advocate for supportive policy changes that open opportunities for deeper anchor investments
• Test innovative solutions for co-ownership of anchor and community strategies and community led and owned efforts

Our Shift work has been advancing efforts that align with these recommendations. For example, we help deepen systemic and accountable anchor engagement through our Healthcare Accountability and Learning Action Network, launched in September 2022 to convene healthcare institutions, including health systems, payors, and healthcare technology companies, and foster a collective commitment to design and implement health investment, data, and governance initiatives that prioritize power shifts from institutions to communities. By holding healthcare institutions accountable, the Network has created an action-learning space that promotes anti-racism, truth and reconciliation, and political education. This builds on our policy work to build capacity and advocate for supportive policy changes that open opportunities for deeper anchor investments, including our co-development of the Healthy Neighborhood Investments Policy Scan and Strategy Map resource and convenings in partnership with Build Healthy Places Network.

Additionally, Shift has actualized the recommendation of testing innovative solutions for co-ownership of anchor and community strategies and community led and owned efforts through our Collaborative Fund. The community leader Investment Committee established the vision, priorities, decision-making rubric, modes of application, decisions, and learning questions for a $200K fund seeded by Blue Shield of California Foundation. The learnings included power sharing, community governance, and centering decision-making within communities to direct health equity resources that can be applied across grantmaking, Wellness Funds, investing, and other participatory funding approaches.

Shift has also been active in leading efforts to co-create a definition of success, supporting communities to define a vision for success through the launch of our Shift Clinic, a focused network building effort for community-led change. Shift's Clinic has been tested across topic areas and geographies to emphasize co-ownership of anchor and community strategies. Instead of solely relying on top-down decision-making processes, the clinic encourages collaboration and shared decision-making among stakeholders -- diversity in planning beyond community partners -- by centering community voices in determining a vision for health and the outcomes that communities want to see pursued. Co-ownership fosters a sense of collective responsibility and empowers the communities to actively participate in shaping their health landscape. Shift is actively pursuing opportunities to deepen engagement with our rural community leader colleagues to launch a Rural Clinic in 2023.

We are thrilled that this resource is out in the world and we look forward to supporting other community-anchor partnerships across the country to realize and deepen equity commitments. We are particularly interested in connecting with coalitions, anchor institutions, and/or community-based organizations interested in discussing co-investment and co-design principles. Please get in touch with us to discuss how we can support your efforts! For more information about this resource or with questions/interest about how we can partner in this work, please contact us at info@shifthealthaccelerator.org or anchorguidance@hcwh.org.