Page 83 Cite

Suggested Citation:"Appendix F: Small Group Exercise Materials." National Academies of Sciences, Engineering, and Medicine. 2022. Reorienting Health Care and Business Sector Investment Priorities Toward Health and Well-Being: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25667.

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Appendix F

Small Group Exercise Materials

Following the panel discussions, workshop participants broke into small groups to discuss investment priorities for health and well-being, as well as organizational and leadership challenges, for the fictional city of Ourlandia.

Page 84 Cite

Suggested Citation:"Appendix F: Small Group Exercise Materials." National Academies of Sciences, Engineering, and Medicine. 2022. Reorienting Health Care and Business Sector Investment Priorities Toward Health and Well-Being: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25667.

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NASEM Roundtable on Population Health Improvement

Workshop on Reorienting Health Care and Business Investments Toward Health and Well-Being

The Predicament

Ourlandia is a mid-sized American city, once the nation’s leading manufacturer of industrial glass; it is also a regional hub for telecommunications, agriculture, higher education, and vocational training. Nearby lakes and forests attract tourism, service industries, and artists.
Fortunes in the glass industry declined a long with all US manufacturing. City leaders were slow to plan for socio-economic transition.
Population declined 15% in 30 years, and will fall more without a redound plan.
Residents include a mix of classes and cultures, all immersed in a long, painful history of residential segregation, concentrated poverty, white flight, suburban sprawl, extreme wealth inequality, disrespect for indigenous people and denial of full human dignity for women, people of color, and other subgroups.
People and the economy suffer from excessively high and inequitable rate of chronic illness, addiction, suicide, violence, poverty, and unjust incarceration. Wildfires have been intensifying, along with eroding air and water quality.
Life expectancy has fallen for the past three years.
More than 60% believe the next generation will live worse lives than their parents.

Your Charge: Participate in the renaissance of Ourlandia

Background in Spotlight Sectors

Health Care	Business Investment
Ourlandia main nonprofit hospital was built in 1908 by wealthy industrialists and Catholic nuns as a free clinic for factory families. Over the past 40 years, two other small hospitals formed and all three eventually merged, as the healthcare sector became a big business unto itself. Ourlandia Hospital is now a major nonprofit center for teaching and research, the second largest employer, and an anchor of the regional economy. The hospital’s current business model is breaking down. Most payers will end fee-for-service payment in the next decade. Half of the pupation is already covered through value based contracts. There is now a strong economic incentive to not only care for acute illness, but also to sustain equitable health and well-being for as long as possible.	Small companies and major corporations that do business Ourlandia are sensitive to strong public expectations regarding fair treatment of workers and customers; product safety; environmental sustainability; and ethical management. Local banks and credit unions support community development and routinely fulfill requirements of the Community Reinvestment Act. Big national banks are sometimes less compliant and have been publicly sanctioned. A large multi-employer pension fund (supporting public and private employees) remains solvent and was among the first to adopt socially-responsible investment criteria, with a focus on living wages, gender equity, and renewable energy.

Health Care

Business Investment

Ourlandia main nonprofit hospital was built in 1908 by wealthy industrialists and Catholic nuns as a free clinic for factory families.
Over the past 40 years, two other small hospitals formed and all three eventually merged, as the healthcare sector became a big business unto itself. Ourlandia Hospital is now a major nonprofit center for teaching and research, the second largest employer, and an anchor of the regional economy.
The hospital’s current business model is breaking down. Most payers will end fee-for-service payment in the next decade. Half of the pupation is already covered through value based contracts. There is now a strong economic incentive to not only care for acute illness, but also to sustain equitable health and well-being for as long as possible.

Small companies and major corporations that do business Ourlandia are sensitive to strong public expectations regarding fair treatment of workers and customers; product safety; environmental sustainability; and ethical management.
Local banks and credit unions support community development and routinely fulfill requirements of the Community Reinvestment Act. Big national banks are sometimes less compliant and have been publicly sanctioned.
A large multi-employer pension fund (supporting public and private employees) remains solvent and was among the first to adopt socially-responsible investment criteria, with a focus on living wages, gender equity, and renewable energy.

Page 85 Cite

Suggested Citation:"Appendix F: Small Group Exercise Materials." National Academies of Sciences, Engineering, and Medicine. 2022. Reorienting Health Care and Business Sector Investment Priorities Toward Health and Well-Being: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25667.

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Examples of Emerging Values & Investments

Below are several early-stage initiatives that are gaining traction and need greater investment to yield Their full value for health and well-being across Ourlandia. Keep in mind that past gains are fragile and must be maintained.

Food Security

Farmar, food distributors, advertisers, schools, and large employers form a joint venture to end hunger and food insecurity

Routine Care & Resilience

Popular mind-body centers offer easy access to affordable preventive and chronic care, smoking cessation, addiction recovery, stress reduction, trauma-informed resilience; and other routine services

Safety & Criminal Justice

Bipartisan criminal justice reform creates a framework for public safety, fair treatment for nonviolent offenses, and an end of the school-to-prison pipelines

College & Wealth

Employers and public educators offer student debt waivers and free college tuition in exchange for work in a new Community Stewardship Corps

Wages & Workplaces

Consumer and hourly workers persuade employers to pay living wages guarantee worker safely and support sick leave, or risk boycotts and other kinds of public backlash

Biotech for Prevention

Engineers and biotech firms team up with glass manufacturer to design the next generation of fiber optics for diagnostic screening and high-speed computing

Ownership & Purpose

Tax policies offer windfall profits to corporations that expand employee ownership or covert B-corporations

OTHERS

There are many other opportunities to enhance vital conditions for health and wellbeing. If you don’t see your highest priorities, be creative and propose something new.

Nature & Land Use

Land trusts convert vacant and abandoned into to playspaces, gardens, and outdoor classrooms

Transportation

New transportation tax credits provides incentives for active transport, mass transit, remote work, and telemedicine.

Racial Equity & Social Justice

City Council debates an ordinance to emphasize racial equity and social justice in all policies and practices

Multisector Accountability

An Accountable Community for Ourlandia’s future launches with 1,200+ organizations from every sector that commit to common portfolio of effective and efficient investments.

Corporate Citizenship

Local media begin to broadcast weekly stories of inspiring corporate citizenship— as well as scandalous examples of greed and harm

Aging at Home

Building codes and tax policies enable seniors to remain at home and age in place

Clean Environment

Carbon pricing and a green building fund improve cost-effective for clean power, clean air and water, while lowering the cost of utilities for families and responsible businesses

Page 86 Cite

Suggested Citation:"Appendix F: Small Group Exercise Materials." National Academies of Sciences, Engineering, and Medicine. 2022. Reorienting Health Care and Business Sector Investment Priorities Toward Health and Well-Being: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25667.

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How Will You Contribute to the Renaissance of Ourlandia?

Step 1: Consider Your Role

You and your fellow group members will play just one assigned role (either a Hospital Board or a Pension Fund Manager). Here is a short descriptions of each role.

Board of Ourlandia Hospital	Pension Fund Manager
Your Role & Strategic Imperatives: Reposition the non profit hospital as a high-value producer of health and well-being for all, not only a place to care for acute illness/injury Establish clear organizational values, investment priorities, and partnerships Generate the greatest possible human and financial value through Strong civic leadership 15,000 employees $4.5B endowment $450M annual revenues $45M annual comm. health improvement	Your Role A Strategic Imperatives: Safeguard and enhance lifelong economic security for working families, while fulfilling obligations for socially responsible investing Establish clear organizational values, investment priorities, and partnerships Generate the greatest possible human and financial value through Strong civic leadership 200,000 workers and retirees $20B assets under management 20+ year time horizon

Board of Ourlandia Hospital

Pension Fund Manager

Your Role & Strategic Imperatives:

Reposition the non profit hospital as a high-value producer of health and well-being for all, not only a place to care for acute illness/injury
Establish clear organizational values, investment priorities, and partnerships
Generate the greatest possible human and financial value through
- Strong civic leadership
- 15,000 employees
- $4.5B endowment
- $450M annual revenues
- $45M annual comm. health improvement

Your Role A Strategic Imperatives:

Safeguard and enhance lifelong economic security for working families, while fulfilling obligations for socially responsible investing
Establish clear organizational values, investment priorities, and partnerships
Generate the greatest possible human and financial value through
- Strong civic leadership
- 200,000 workers and retirees
- $20B assets under management
- 20+ year time horizon

Step 2: Identify Your Priorities for Value & Investment

Review emerging opportunities, consider trade-offs, and name your priorities (15 minutes)
Describe major changes in organizational role and leadership challenges (20 minutes)

Questions	Responses
Which are the most compelling priorities to enhance value for your organization and for Ourlandia? Bonus: Write a short headline
How do these priorities reposition your role in Ourlandia?
What trade-offs did you consider when setting your priorities?
What leadership challenges will you have to overcome (within your organization or with others)?

Reorienting Health Care and Business Sector Investment Priorities Toward Health and Well-Being: Proceedings of a Workshop (2022)

Chapter: Appendix F: Small Group Exercise Materials

Appendix F

Small Group Exercise Materials

NASEM Roundtable on Population Health Improvement