Financing Workbook


Beyond the Grant

A Sustainable Financing Workbook

beyond-the-grant-img Long-term, sustainable financing is a major challenge for the majority of multisector partnerships, and the organizations aligned with them, in regions across the country. Many depend overwhelmingly on short-term sources of funding—namely, grants. It’s time to explore new financing frontiers!

This workbook offers modules with practical, user-friendly tools to answer common financing questions and develop action plans for moving beyond the grant.
If this is your first time here, scroll down for a quiz that will help you determine the best place to start. If you're looking for printables (worksheets, not the entire module), you can find them by clicking on the relevant module.

START by reading the preface.

NEXT dive into the introduction or skip to the module that most interests you!

START by reading the preface.

Before you dive in . . .

It’s high time to open new doors to sustainable financing structures. Take a minute to find out how to get ready.

NEXT dive into the introduction or skip to the module that most interests you!

What is this thing? Will it really help you finance your work?

Is this book for you? (Probably!) Find out what it can do for you and your multisector partnership or organization.

Click ‘download’ above to access the entire Module and below for a separate, printable copy of a resource on integrative activities.

Module 1
How do you move money across sectors and organizations?

Right now, there’s a lot of money flowing through your region. (trust us: a LOT). If you could capture just a sliver of that, you could make some serious progress. How do you do that? Well, let’s start by exploring how others have done it.

Click ‘download’ above to access the entire Module and below for a separate, printable copy of the worksheet.

Module 2
What is a system (and how does it influence who wins and loses)?

Systems, systems thinking, systems-oriented . . . enough already! What the heck is a system anyway? Find out how understanding it can help your partnership or organization achieve its goals.

Click ‘download’ above to access the entire Module and below for separate, printable copies of the worksheets.

Where can you find money for your work (and how do you get it)?

Got grants? Great! Now let’s talk about some other funding sources and see which ones are right for your partnership or organization!

Click ‘download’ above to access the entire Module and below for separate, printable copies of the worksheet and the related resource.

Module 4
How much will your dreams cost (and how do you estimate those costs)?

Creating a financial plan sounds daunting, but it’s really important (and painless, we promise!). You’ll gain insight into your work just by trying. Don’t worry if you don’t know the numbers—just dive in!

Click ‘download’ above to access the entire Module and below for a separate, printable copy of the worksheet and the related resource.

Module 5
What value do you create?

You know your work is valuable, but how do you demonstrate that to others? ReThink Health’s Value Sequence can help you identify the value you create, add evidence, and successfully “make the case” for funding.

Click ‘download’ above to access the entire Module and below for separate, printable copies of the worksheet and the related resource.

Module 6
How much should you charge for your services?

Yes, your collaboration can charge for the services it provides! But how do you even begin to decide what amount to charge? It’s not as hard as it sounds.

Module 7
What integrative activities could you get paid for?

“Integrative activities” used to be thought of as coordinating work done by “backbone” organizations. But many organizations share the task of governing and managing collective efforts, and these tasks can be the hardest to fund. Explore the different integrative activities and find out how other partnerships fund theirs!

Click ‘download’ above to access the entire Module and below for a separate, printable copy of the worksheet.

Some final thoughts—and many thanks!

Let’s wrap things up and take a moment to thank those who made this workbook possible.

Let’s get on the same page about terminology.

Cracking open the workbook and seeing some terms you don’t recognize? You’re not alone, so we’ve put together this glossary. Refer to it as needed while you explore the workbook!

The nitty-gritty of integrative activities and financing structures.

Want a reference for what integrative activities are and how to demonstrate their value? How about more details on financing structures? We’ve got you covered!

Click below for separate, printable copies of each appendix.

Your magical assistant for creating a financial plan—or at least as close to that as a spreadsheet can get.

Got a finance plan? If not, our Financing Wizard can help! Hone your skills by playing around with a test case, or dive in and mock up a plan for your collaboration. Our easy-to-use Microsoft Excel template gives you all you need to start your collaboration’s financial plan today. Note: please select ‘Enable Macros’ when prompted.

Click ‘download’ above to access the entire Financing Wizard and click below for the instructional Handout.

Is Beyond The Grant for you?
Local elected officials and city agency staff address social determinants of health every day in resource-constrained contexts. This Financing Workbook emphasizes partnerships and strategies that are pre-requisites to funding and helps city leaders think through a range of financing structures and their applicability in different contexts. Special thanks to ReThink Health for creating this practical, valuable resource for the wider community.
- Kitty Hsu Dana, National League of Cities  
Explore ReThink Health’s financing work: on the blog

ReThinking the Quest for Sustainable Financing: Exposing Our Assumptions

As communities create plans for improving health and health care, the quest for financing often begins with the question, “Where can we get the money we need?” Financing is viewed as a budgeting exercise, with the task of securing resources equal to expenditures.


ReThinking the Quest for Sustainable Financing: Innovative Financing Mechanisms: The Holy Grail?

The purpose of any financing mechanism is to marry the value being created (e.g., reduced diabetes costs) to those who care about that value and are willing to pay for it (possibly health providers, payers, or the patients themselves in the case of diabetes).


ReThinking the Quest for Sustainable Financing: Choices, Abundance and Leadership: How Do We Decide Where the Homeless Man Will Live?

It’s possible we live in a world of abundant resources, but our choices are lacking. How long can we continue to make money the solution instead of acknowledging that disagreements in our underlying values, mental models, and moral positions shape our choices about how to use resources?


Financing Population Health: It’s Time to Start Thinking Beyond the Grant

Partnerships for population health are relying too much on grants! The public sees intrinsic value in all sorts of investments— for instance, if there’s a job to be done in affordable housing, they have centralized federal financing schemes like Section 8—can stewards work together to get the public to make similar investments in health and well-being?


Could Monopoly Money Produce Better Results in Population Health?

Population health isn’t a game—but in this blog, we spotlight how a food bank used a fake currency to create an elegant bidding system that ensured food went to where it was most needed.


Is This Any Way to Run a Business? A Population Health Business, That Is!

Most population health efforts are funded by grants, but these huge, important dreams deserve a more sustainable, dedicated source of funding. Can thinking like business start-ups help stewards stake their claim to funding?


What Can Population Health Learn About Financing from Affordable Housing and Community Development?

Affordable housing and community development have some pretty major financing sources in place, such as Section 8 vouchers and the Community Development Block Grant—but they didn’t appear overnight. Here are some case studies of how these fields developed their central financing structures, and what stewards can learn from them and apply to population health.


Turning Assets into Revenue: For Population Health Financing, Start with What You’ve Got

Good news, stewards: you are probably doing something valuable, and worth financing, that you aren’t yet thinking about financing! Learn more about identifying where the value is and how to make the case for getting paid for population health work.


Seeking Financing for Population Health? Here Are 5 Resolutions for the New Year

Stewards can change their own mindsets to recognize that making financing choices is a gift—not a burden. Check out these tips for starting down a new sustainable path.


We’ve Got Choices in Population Health Financing, So Let’s get Really Good at Making Them

Fundamentally, financing is about choices. Learn how you can embrace a new financing narrative that will help you develop innovative and successful approaches for pursuing population health in your region.


One More New Year’s Resolution: Dream Big on Sustainable Financing

Six leads for stewards as you consider pursuing sustainable financing. Can taxes help fund health and well-being? How can private businesses help, whether as partners with nonprofits and as employers?


The Sense—and Nonsense—of Using ROI in Population Health

Return on investment (ROI) in population health is complex; it’s often unclear what counts as returns, and who benefits. Even worse, many funders apply uneven standards to health efforts compared to products (such as drugs and devices), and undervalue social returns in favor of financial ones. Here, we explore how stewards—and the health field as a whole—can make ROI work for them (and identify when it should be removed from the equation).


Considering a Social Impact Bond? Tread Carefully.

Social impact bonds have potential—but are they destined to be a flash in the pan? With so much talk about the upsides already in the public discussion, we spoke with dozens of leaders in the field, and consolidated their thoughts on what more ought to be considered before jumping into such an arrangement.


Sugar-Sweetened Beverage Taxes: Tying Revenue to Population Health Sweetens the Deal for Communities

Sugary drink taxes have the potential to be a win-win for residents: improving health while at the same time raising revenue. Read some success stories from across the country, and some key takeaways from those examples, such as ways to build support, and the importance of transparency.


Does Your Backbone Organization Sustain Itself Without Relying Entirely on Grants?

While some partnerships have a single “backbone” organization that handles integrative activities, it’s more common for that work to be distributed across stewards involved with the partnership. This means stewards need to think differently about sustainable financing strategies. Here are our early thoughts.


Successful Population Health Initiatives Must Address Negative Consequences

Taxes on sugary drinks have been shown to be effective at improving population health—but what about the businesses that rely on those drinks to make a profit? And could the tax damage the community, for instance by removing jobs or creating new financial burdens for residents? Stewards need to be aware of the potential for these sorts of unintended consequences of taking action to improve health. In this blog we offer some ideas for averting them.


An ROI Worth More Consideration: Population Health as a Path to Economic Development

Current investments in economic development are underperforming, and at the same time, the impact of health and well-being on the economy is becoming more apparent. Stewards could consider the potential of investing in health and well-being to generate economic prosperity.


Mini Municipal Bonds: Putting the Public Back into Public Financing

Explore the benefits of mini municipal bonds, an innovative way to help residents invest in improving their own towns and cities—and increase their civic engagement.


Moving Beyond the ‘Where Do I Get My Next Grant?’ Mindset: What We Learned About Sustainable Financing from the Pulse Check

We share findings from the 2016 Pulse Check survey around financing. Do stewards have financial plans? What do they need to fund? What sustainable financing options are they exploring?


Financial Plans for Regional Health: How Much Will Our Dreams Cost and How Will They Be Funded?

Learn more about financial planning for multisector partnerships and organizations pursuing regional health and well-being—why you’d want to do it, what the basic practices are—and look at a real-life example of financial planning for regional health in action.


Where Can Regions Find the Money Needed for Population Health Initiatives?

Introducing A Typology of Potential Financing Structures for Population Health, which lists and describes mechanisms that stewards could use to gain funding for population health efforts.


Could Tax Credits Be a Source of Sustainable Financing for Population Health?

We clear up some misconceptions about tax credits and go over the basics of how they might be used to fund population health efforts. It’s time to cut through the myths and see where the real opportunities lie.


Establishing a Charitable State Tax Credit to Finance Regional Wellness Funds

We developed a prototype for how stewards might introduce a tax credit that encourages charitable donations to wellness funds (pools of money for funding efforts to improve health and well-being). We explain the key differences between a tax credit and a tax reduction, and explore why local—as opposed to federal—control is key to directing funding where it is needed most.


Incenting the Private Sector to Invest in Population Health: A Tax Credit for Self-Insured Employers

We developed a prototype for how state policymakers could create a tax credit for self-insured employers, which would engage the private sector in transforming population health.


A Typology of Potential Financing Structures for Population Health

There are no easy, easily accessible sources of sustainable funding. There are no magic shortcuts. But there are a variety of innovative options being used across the country. And there is a way of thinking about these options that can point you in the right direction. We have summarized these options in this Typology.


New ReThink Health Workbook Takes the Fear Out of Financing

It’s time to stop relying solely on grants, and find ways of paying for health transformation work that will last over the long term—but financing can be an intimidating topic. That’s why we introduced Beyond the Grant: A Sustainable Financing Workbook, which uses colorful examples, engaging exercises, and plain, everyday language to help stewards do what it takes to expand their financing horizons.