Purpose

The workgroup was created to explore:
The value and process of developing a business case to payers demonstrating the value of upstream programs;
Strategies for negotiating capitated rates with Medicaid and commercial payers that include payment for upstream prevention efforts; and
Identifying the most viable strategies for supporting integrated health models and the essential role that community health workers play in them.

Workgroup Members

Members of the MHCU Financial Sustainability Workgroup were:

Emerging Lessons

Additional Resources

Making an Effective Business Case
Core components of business planning, case studies, and resources- presented by Avivar Capital

Business Planning Guide
Overview of the 10 steps needed to create a compelling business case for upstream work

Engaging the “Right” Stakeholders in Upstream Prevention
From ReThink Health, considerations for engaging stakeholders in upstream work

Fact Sheet: CDC’s 6-18 Initiative
Summary of a CDC initiative aimed at accelerating the adoption of evidence-based prevention