Funding Profiles of Multisector Health Care Alliances

How do Funding Profiles of Multi-Stakeholder Collaboratives Affect Their Positioning for Sustainability?

Collaborative forms of organizations (e.g., alliances, coalitions, networks) are increasingly viewed as an effective means for addressing complex health and social problems in a community or region. Unlike traditional, hierarchical organizations, collaboratives rely heavily on volunteer stakeholders to formulate strategy, coordinate diverse activities, and implement change at the community level.

Sustaining effort and participation by stakeholders in collaborative organizations is often challenging and may depend on the amount, source and diversity of funding available to support these types of organizations over the long term. For example, dependence on contracts that require specific programmatic activities may foreclose certain strategic and operational opportunities.

Building on existing literature related to revenue diversification in non-profit organizations, this mixed methods study examined the relationship between collaborative funding profiles and volunteer stakeholders’ views on positioning for sustainability. These relationships were tested in eight collaboratives that participated in a ten-year program designed to improve the quality and outcomes of health care on a regional level.

Findings indicate that, in general, members of alliances with more diverse revenue sources believed that the alliance was better positioned with respect to its goals, strategies, and appropriate leadership in the coming years and less likely to face challenges to sustaining its efforts. Over-dependence on grant revenues, in particular, may be problematic for how well alliances are positioned for sustainability, in part because grants can be restrictive in terms of developing general infrastructure and capacity to pursue future programmatic opportunities. While a number of approaches were identified to reduce dependence on grants, implementing these strategies presented a challenge of striking a balance between pursuing alternative revenue sources and maintaining the “neutral convening” role valued by many of the participants.

The findings discussed may help collaborative leaders be more informed about their funding choices and the trade-offs inherent in them. Likewise, the findings can help funders and policy-makers better understand the unique challenges that collaboratives face in securing revenue and maintaining the efforts of their members.

Authors:  Larry Hearld, Jeffrey Alexander, Laura Wolf, Yunfeng Shi
Funding Profiles of Multisector Health Care Alliances and Their Positioning for Sustainability
Journal of Health Organization and Management.  2018 Jun 18;32(4):587-602.