What's Next for Healthcare Philanthropy After the ACA Battle? We're Starting to Find Out

For years, the battle over the Affordable Care Act sucked up big funding resources, along with the mental bandwidth of many funders, and it's still not over, with lots of dollars aimed at geting people signed up and the unfinished battle to extend Medicaid to more states. 

Now that the United States has joined the rest of the civilized world in enacting universal coverage, it's clear what's coming next: Improving the actual health and well-being of Americans. This is hardly a new focus of health funders, of course, but now it's moving front and center and getting more interesting. 

We wrote yesterday about the big changes at RWJF along these lines. Today, we take a look at what the Kresge Foundation is up to, which offers more evidence of the shift underway. Just this week, Kresge announced a pair of three-year, $2.25 million grants to health research and policy pioneers Nemours, in Wilmington, Delaware, and the UCLA Center for Healthier Children, Families, and Communities, in California.

The whole enchilada is called “Moving Health Care Upstream,” and it’s designed to foster the growth of healthy communities by identifying daily activities that lead to improved health, and encouraging those activities. Meanwhile, communities will network with each other to share outcomes and feedback.

Essentially, the shift here is away from “care” and toward “health”—because when there’s health, there’s markedly less need for care. That's obvious, right? But somehow, this elementary truth got lost in the background amid the American obsession with finding silver bullets to slay various dread diseases, not to mention decades of drama over how to insure everyone and also contain spiraling costs. 

“Moving Health Care Upstream will catalyze and extend the reach of innovations designed to transform our health system from one that primarily focuses on rescue care for those who are already sick, to one that can effectively optimize health by efficiently modifying the conditions that lead to illness,” offers Neal Halfon, PhD, director of the Center for Healthier Children, Families and Communities.

Amen, brother. And it's great to see Kresge empowering the likes of Halfon at the same time that RWJF is rolling out its big "Culture of Health" push, which officially launched earlier this summer after a long incubation.

RWJF wants wellness to become part of our culture; Kresge wants to look at the “upstream” harbingers of such health problems as bad eating habits and change them before they create bigger problems down the line.

“A growing number of health systems, local governments and non-profit partners are turning their attention to improving ‘population health’,” says Chris Kabel, a senior program officer at Kresge. “What this term really means is that we’re working to achieve broad gains in health across a community or geographic area, not just on a patient-by-patient basis.”

The neat thing is that both programs were inspired directly by the Affordable Care Act, which is suddenly making it easier and more appealing for health philanthropies to emphasize community health through avenues like access to healthy food, exercise, safe, affordable housing, and freedom from pollution. Which is to say that the last big health fight has set America up for the next big one.