pay for success (pfs): validating your program’s cashable benefits to secure private sector...

8/19/2019 Pay for Success (PfS): Validating Your Program’s Cashable Benefits to Secure Private Sector Investor Funding by Michael McKnight

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www.ghhi.org©2015 Green & Healthy Homes Initiative. All rightsreserved.

What is Pay For

Success?Pay for Suess !P"S# models are ross$

setor %artnershi%s in hih %rivateinvestors %ay u%front for a soialservie and then government or

healthare %ayors re%ay the

investment if and only if agreed-upon outcomes are met.

If outcomes are not met, investors losemoney


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Basic PFS Mode

Gra%hi' (Pay for Suess !P"S# "inaning)* Soial "inane. "ound in (Pay for Suess' A Primer for Soial Innovators)* Soial Innovation "und

http://www.nationalservice.gov/sites/default/files/documents/SIF%20-%20A%20Primer%20on%20Pay%20for%20Success.pdfhttp://www.nationalservice.gov/sites/default/files/documents/SIF%20-%20A%20Primer%20on%20Pay%20for%20Success.pdf


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Basic PFS Mode




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Basic PFS Mode




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Basic PFS Mode




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Basic PFS Mode




7/25www.ghhi.org©2015 Green & Healthy Homes Initiative. All rights

reserved.

Basic PFS Mode


If outomes notahieved)

government+%ayorma,es no %ayments

to investors. Potential%ro-et essation.

&utcomes notachie'ed




reserved.

PFS )cti'ity in the *.S.

10

Ative

1

Inative%dated /ovemer

2015

11 P"S %ro-etslaunhed fouson'- riminal

-ustie+reidivism

- arly hildhoodduation

- 3aternal+hildHealth

- Homelessness

40 other P"S

%ro-ets infeasiility %hase

P"S legislationintrodued atfederal level &

%assed in multi%lestates



reserved.

Bene,ts o PFS

Progress toards systemi hange

6ridges timing ga% eteen servie%rovision and ost savings

Pay for hat or,s

Stale) 7e8ile funding to servie

%rovidersShifts fous from remediation to%revention

9igorous %rogram evaluation



reserved.

PFS /haenges

:engthy feasiility and transationstruturing

ost savings an e di;ult toasertain

:imited su%%ly of a%%ro%riate

interventionsHigh transation osts

6ureauraies and silos



reserved.

&ptima PFS

0nter'entionsvidene$asedProviders strutured for evaluation

Generate ashale savingsost$e


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he PFS &pportunity

or )sthmaS&/0)0MP)/$.(M ,ids ith asthma in .S. !14.=3adults#

1"M missed shool days due to asthma

+M families living in unhealthy homes

Soures' enter for >isease ontrol and Prevention !htt%'++.d.gov+nhs+fastats+asthma.htm# (GHHI' Im%roving Health) onomi) and Soial ?utomes @hrough Integrated Housing Intervention)* Environmental Justice, ol. =) /umer B) 201C

/)S3)B4S)5067S

P8&54606485460&6"9 of asthma e%isodes aused y home$ased triggers

GHHI Healthy Homes >emonstration Pro-et'

BBD asthma hos%italiEations B2D %artii%ants ith 0asenes

24D asthma > visits 44D %artii%ants ith0 missed or, days

:#; - :1#; %erhos%italiEation

:# - :# visit

?ther 98 & urgent are

osts

:#$B s%ent on asthmaannually


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4'idence Base or

3eathy 3omes• /APP Guidelines$ased are allsfor1# Assessment of disease

severityF

2# 3ediationF# Patient eduationF and"= 4n'ironmenta contro

• HHSs ommunity Preventive

Servies @as, "ore found>strong e'idence oeecti'eness o in-homeen'ironmenta inter'entions@ in im%roving asthma management

and overall uality of life for

Surgeon7eneraAs /ato )ction toPromote3eathy 3omes2+=• ost eneJt studies sho a return of :# to

:1" per :1.


14/25


)ddress 8oot /auses at

3ome *nheathy 3ome

)sthma4pisode

3ospita5isit

reatmentC

0nhaer


15/25


/ommon 3ome )sthma

riggersDust Mites

/oc;roaches

Pests

Mod

5&/s

oEacco Smo;e

)nima

)ergens

Smo;eC7as


16/25


3eaing a FracturedDei'ery System


17/25


he 7330 >6o WrongDoor@ Mode

ead 3aard8eduction

)sthma rigger/ontro

FaC0nGuryPre'ention

4nergy 4Hciency

Weatheriation


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0mpactI Buiding aBusiness /ase

1Peer-reviewed and published in Environmental Justice journal

Green & Healthy Homes Initiative: ImprovingHealth, Economic and Social Outcomes ThroughIntegrated Housing Intervention

• $$9 redution in asthma$related lienthos%italiEations

• 2(9 redution in asthma > visits

• #9 inrease in %artii%ants never havingto visit the dotors o;e due to asthmae%isodes

• $29 inrease in %artii%ants re%ortingasthma$related %erfet attendane for theirhild !0 shool asenes due to asthmae%isodes#

• ((9 inrease in %artii%ants re%ortingEnvironmental Justice, ol. =) /umer B) 201C


19/25


8educed /osts J /ashaEeSa'ings

• 1 asthma-reated hospitaiationon a'erage costs :%#$ inBatimore

• 1 asthma-reated emergencyroom 'isit on a'erage costs :(2

in Batimore)sthmahospitaiations and 4D

'isits

/ashaEe

Sa'ings

K200L$10dataM


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)sthma PFS Mode

Gra%hi altered from' (Pay for Suess !P"S# "inaning)* y Soial "inane) in (Pay for Suess' A Primer for Soial Innovators)* Soial Innovation "und

olletive Goal'

I3P9? HA:@HA/> S?IA:?@?3S

Investors

Intermediary

Servie Providers

Inde%endentvaluator

Healthare Payor

Asthma HightiliEers

1

alidate savings andtrigger suess

%ayments

Investment %aysfor ost of

intervention

= 9e%ay %rini%al andreturn

2>ra don funds

to %ay forintervention

Home

remediation and

eduation

5

C valuateoutomes

B3a,e suess%ayments from ostsavings

"lo of funds Servies& valuation

7330 B ti PFS

http://www.nationalservice.gov/sites/default/files/documents/SIF%20-%20A%20Primer%20on%20Pay%20for%20Success.pdfhttp://www.nationalservice.gov/sites/default/files/documents/SIF%20-%20A%20Primer%20on%20Pay%20for%20Success.pdfhttp://www.nationalservice.gov/sites/default/files/documents/SIF%20-%20A%20Primer%20on%20Pay%20for%20Success.pdf


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7330 Batimore PFSMode

Gra%hi altered from' (Pay for Suess !P"S# "inaning)* y Soial "inane) in (Pay for Suess' A Primer for Soial Innovators)* Soial Innovation "und

olletive Goal'

I3P9? HA:@HA/> S?IA:?@?3S

Asthma HightiliEers

1

alidate savings and

trigger suess%ayments

Investment %aysfor ost of

intervention

= 9e%ay %rini%al andreturn

2>ra donfunds to %ay forintervention

Homeremediation and

eduation 5

C valuateoutomes

B3a,e suess%ayments fromost savings

"lo of fundsServies & valuation

& otherinvestors

Philanthro%i

Guarantee



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GHHI seleted to %artii%ate in Soial Innovation"unds Jrst P"S ohort develo%ing asthma P"Sfeasiility studies in 5 loations.

*ni'ersity o*tah 3eathPansSat a;e

/ounty

Spectrum3eath3eath 6etK3eathy3omes/oaitionK L)sthma6etwor; o W.Michigan

e Bonheur/hidrenAs3ospita3aEitat or3umanity o7reaterMemphis LMemphis /3iD

MonroePan/ommunityFoundation

or 7reaterBuao

Baystate3eathPartners ora 3eathier/ommunityKSpring,edPartners or/ommunity

)ctionK8e'itaie/D/K L 3)P3ousing

BueI Healthare

organiEations

7reenI Servie Providers

) th PFS F iEiit


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)sthma PFS FeasiEiityStudies imeine

un21

#

u21

#

)ug21

#

Sept

21#

&ct21#

6o'21#

Dec21#

an21

$

FeE21

$

Mar21$

)pr21

$

May21

$

un21$

@AServies

1 Pro-et Plan

2 >ata9euest

! Payment3ehanism

" Assess SPa%aity

# "inanial3odel

$ "inaliEeIntervention

% valuation3odel

( SurveyInvestors

+ Sta,eholderngagement

1 @ransationPre%

De,ne target popuation.Pu cost data.

in; sa'ingsproGections to

success payments.

PFS Eudget.Process Now and

scaingeOpectations.

Determine source osuccess payments.

)ssess currentcapacity and

identiy needs.

4'auationmethod

0n'entorynationa L

ocain'estors 4ngage nationa L oca

sta;ehoders across puEicKpri'ateK and socia sectors

Finaie easiEiityreports and prepare

or transaction phase

8oes LresponsiEii

ties

FinaeasiEiityreports L

transactiondecision

/ohort modeI

• Share learningsand ma,eonnetions

• ross$site

einars

• All$siteonvening in/ovemer


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Poicy 4nd 7oas

3S & other health %ayers overing healthyhomes servies

Physiians riting %resri%tions for healthy homesservies

Housing %rofessionals eing a ne front line forhealthare

Hos%itals utiliEing ommunity eneJts to ,ee%

%eo%le healthier) rather than %aying forunderom%ensated are

Inreased data around the road im%at ofhealthy homes

pay for success (pfs): validating your program’s cashable benefits to secure private sector...

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