“Health, Not Just Healthcare.” How a Key Funder in Texas Looks Beyond the Doctor’s Office

With over $1.2 billion in assets, the Houston-based Episcopal Health Foundation (EHF) plays a major role in providing healthcare for 11 million Texans in a 57-county service area, though it’s relatively young, having just launched in 2013. Its five-year strategic plan, as we’ve reported in the past, takes a three-pronged approach to health funding, emphasizing community-integrated care, non-medical contributors to health (from adverse childhood experiences to poverty and abuse), and the importance of early childhood development.

EHF recently announced a new $17 million investment in Texas community-based clinics and rural care providers. The funding will go toward community-integrated, value-based, comprehensive care in order to promote the health of rural, uninsured, and low-income Texans at every level. In keeping with the spirit of their slogan, “Health, Not Just Healthcare,” EHF’s new grants reflect two ongoing trends in health conversion foundations’ funding: a movement toward value-based care, and an increased focus on social determinants of health.

Value-based models of care focus on patient health outcomes rather than sheer volume of healthcare services, with an eye on promoting health at every stage. While volume-based care is often concentrated in the “crisis” stage of health—in emergency rooms and urgent care centers, for example—value-based care emphasizes behavioral and mental health, preventative care, and patient education, especially for people with complex medical needs or chronic illnesses.

“Comprehensive, community-based clinics offer the full array of services, including immunization and women’s reproductive health services, charge patients according to a sliding scale, participate in reimbursement systems, and seek out a variety of sources of funding for sustainability,” explains Brian Sasser, EHF’s chief of communications.

To that end, EHF has dedicated $9.1 million to community-based “comprehensive care,” such as dental care, specialty referrals and behavioral and mental health treatments for low-income and uninsured populations. Meanwhile, Austin’s Integral Care will receive a $1.5 million grant to develop pilot models of value-based payment and care at two Travis County clinics. Another $500,000 will specifically fund the expansion of mental healthcare and referrals in rural clinics.

EHF’s new grants also zero in on non-medical determinants of health, especially issues like housing insecurity, poor nutrition and poverty, all of which are linked to chronic disease. “More medical care alone won’t improve the health of communities, especially in low-income and rural areas,” Sasser asserts. “Non-medical factors like poverty, neighborhood safety, access to healthy foods, access to safe exercise areas, education levels, and many other social conditions have a huge impact on any person’s health.” While accessing medical care is crucial, EHF’s press release explains, non-medical factors are potentially responsible for up to 80 percent of a given patient’s health outcomes.

With EHF’s funding—primarily through the Texas Community-Centered Health Homes (CCHH) Initiative, which helps clinics go “beyond the doctor’s office” to address social determinants of health for rural and low-income Texans from the ground up—clinics in Katy, Austin, Tyler, Houston, and several other Texas cities will be able to connect patients with resources like transportation, financial assistance and safe housing. Other grants in this area focus specifically on combating food insecurity, obesity and teen pregnancy. The funds will also be used to train providers in addressing mental health issues before patients reach a crisis point.