Foundations have fostered innovation in health and health care for the better part of the twentieth century. Many of these innovations are well documented and widely acknowledged. What’s less documented and largely unquantified is the impact foundation investments can have in helping to ensure that the voice of the American consumer is heard in health policy debates. This is particularly timely as work gets underway to implement numerous provisions of the Affordable Care Act in the months and years ahead.
As part of its long-standing mission to develop policies and programs to expand health coverage in the U.S., the Robert Wood Johnson Foundation (RWJF) established Consumer Voices for Coverage (CVC) in 2007. RWJF funded 12 state-based advocacy organizations—each representing a network of consumer groups across their respective states. Their charge was to designate a state leadership team, then establish and orchestrate common objectives, policy priorities, and coordinated advocacy campaigns.
To track the program’s success, RWJF commissioned Mathematica Policy Research to closely follow and evaluate CVC across six categories: 1) building coalitions; 2) generating grassroots support; 3) analyzing health policy research; 4) designing and implementing health policy campaigns; 5) crafting media and communications strategy; and 6) fundraising. Mathematica interviewed 73 policymakers across 12 states.
The result? Hearing the voices of consumers makes for better policy-making.
Sixty-two percent of policy-makers from the 12 states surveyed said consumer groups increased their influence during the course of the program, demonstrating the significant impact that targeted foundation investment can have in the realm of consumer advocacy.
Key lessons from the program are highlighted in the September 2011 Health Affairs, including that, when making grants to advocacy coalitions, funders should:
- Assess the advocates’ cohesiveness and ability to integrate new members early on, and, if needed, arrange for technical assistance to expedite collaboration;
- Give consumer advocates flexibility to respond to changes in policy priorities and environments;
- Measure a variety of policy outcomes when evaluating advocacy efforts;
- Focus on strengthening advocacy capacity; and
- Try to ensure sustainability from the start.
If foundations wish to ensure that consumer advocates have a voice in state-level debates, they can draw on the CVC experience and use these lessons to guide funding and evaluation strategies moving forward. That RWJF was able to achieve across-the-board success in diverse states demonstrates that regardless of topic, hearing from consumers results in better health policy-making.
Andy Hyman is team director for the Robert Wood Johnson Foundation’s Coverage Team and Sue Sherry is Deputy Director of Community Catalyst