Brenda R. Sharpe
President & CEO
2015 was a year of re-envisioning and planning for the
REACH Healthcare Foundation for our next five years.
The foundation’s 17-member Board of Directors and staff completed a strategic planning process in 2015 during which we reviewed our community investments over several years, and considered where our work had yielded positive outcomes or faltered. Drawing upon health data, community input, and Board and staff reflections, we began to refocus and project where foundation resources might leverage greater impact over the next five years.
The plan that emerged in 2015 ultimately did not constitute a dramatic departure from the foundation’s longstanding commitment to health care access and quality of care. Instead, we adopted a plan that represents a sharpening of our focus on the foundation’s core commitment to these areas.
When we began the planning process, the health insurance marketplaces had only been in operation for two years. Although Kansas and Missouri opted to use federally facilitated health insurance marketplaces and chose not to expand Medicaid, we could see the power that the ACA and the health insurance marketplaces held to dramatically reduce the numbers of uninsured in our service area. The ACA has served as a lever for a number of improvements in quality and capacity. State elected leaders in Kansas and Missouri have not taken advantage of the opportunities the law has presented, but even so, we have been able to document improvements in health insurance status and the quality and capacity of the health care safety net to serve people previously left out.
As the Board and staff began to frame our 2016-2020 strategic plan, we focused on the leverage points and the barriers that continue to get in the way of equitable access to quality, affordable health care. Our questions were:
What would it take to substantially increase the numbers of people with health coverage, and what strategies could we undertake to ensure that the most underserved people in our service area were being reached?
Through the foundation’s community investments in organizations working to address health inequities, such as the Cultural Competency Learning Community and the Urban League of Greater Kansas City, which produced a report in 2015 documenting disparities among African Americans and Hispanics in Greater Kansas City, we have come to a greater understanding of the health, education and economic disparities that prevent people from accessing affordable health insurance and high-quality health care services; and that persistent structural and cultural barriers reinforce these enduring health disparities. While our region has seen improvement in health access with the implementation of the ACA, thousands still lack basic health insurance coverage and continue to confront barriers to care.
With this framework for improving health equity, and the opportunity to leverage existing public resources, the foundation committed to a new five-year strategic plan that will focus our community investments and policy efforts on achieving results in three key areas:
- Enrolling all eligible people in the health insurance marketplace or existing public health insurance programs;
- Closing the health coverage gap through expanded eligibility/availability of Medicaid and other publicly funded insurance options; and
- Strengthening the capacity of the safety net and community to provide high quality, integrated care for consumers with no or inadequate health insurance coverage.
Many of the grants awarded in 2015 were reflective of these interests. The foundation awarded grants to 11 organizations providing enrollment assistance throughout the second open enrollment period of the Health Insurance Marketplace. Grantees included the Community Health Council of Wyandotte County, which pulled together health care, higher education, public health and social service partners and created “store-front” locations to provide enrollment assistance.
Another area of interest is care coordination and health care navigation, services that increase people’s ability to effectively access health services once they obtain coverage. In Kansas, El Centro, Inc., provides intensive care coordination to Spanish-speaking adults to help them secure preventive and specialty health care. The Migrant Farmworkers Assistance Fund in Lafayette County, Mo., helps migrant farm workers obtain health care, legal and other basic services. At reStart, Inc., a Kansas City-based homeless services organization, staff provide care coordination services to homeless individuals with a goal of improving their health outcomes.
As the next strategic plan is implemented, we will continue partnerships with a number of our current grantees, and expect to seek out new partners that have expertise and trusting relationships with individuals and population groups that are not currently being served by existing health care systems. We know this work will not move in a straight-line direction, but we will learn from our experiences and partners, and adjust as we monitor results. As we have introduced our health equity focus and new theory of change, we are encouraged by the interest of other health providers, advocates and funders in working together to create a stronger system for chronically underserved populations. We look forward to sharing our progress and lessons learned along the way.