SIPPRA: Social Innovation Kool-Aid, or Trickle-Up Moneymetrics?
Pay for Success meets the Social Determinants of Health
A version of this article originally appeared in The Dispatch, our weekly newsletter on social innovations in health.
Introducing SIPPRA: A New Funding Stream for SDOH Innovation
The Social Impact Partnerships to Pay for Results Act (SIPPRA) is a new funding opportunity from the Department of the Treasury to “finance outcomes based payments for social impact partnership projects.” The Center for Healthcare Strategies (CHCS) has published a timely new blog post summarizing the details. Here’s the short version:
- $66m in outcome-based payment for social impact projects
- Projects can last up to 7.5 years — enough time to show an ROI
- Applies to Medicaid & CHIP-based programs spanning chronic disease, homelessness, disability, child, adolescent, and maternal, health and more
- Funding goes straight to project teams rather than agencies
- There is a role for 3rd party evaluators to measure and manage the projects (see below)
We turned to the digital water cooler to ask some of the nation’s leading policy and payment experts in social innovation for their early impressions, skepticism, hopes, and other thoughts. A quick tweet roundup:
Measuring Up: Payment & Policy Metrics for Social Impact
SIPPRA represents the latest public funding stream into the broader pool of resources available for health systems and partners to address the social determinants of health (SDOH). But new solutions to address upstream prevention in health typically begin at the experimentation phase, with projects preceding programs. As we’ve recently seen, these petri dish projects can generate tremendous insights on the solutions and the broader market opportunities at play.
As pilots of all stripes quickly pile up, the ability to measure both outcomes and process is growing into a critical competency for innovators to master. In particular, Pay for Success programs hinge on successful measurement of two key areas: the ongoing progress of the intervention, and the end result at the completion of the evaluation period.
A timely article from Third Sector Capital explores how to assess short-term work while building in long-term assessments. Using the example of a housing for the homeless program Santa Clara County, the piece dissects the key metrics in play:
- Payment Metrics are often short- or medium-term performance indicators that track progress, e.g. “days in stable housing” is a measure of the number of days that formerly homeless individuals remain safely housed and off the street
- Policy Metrics are long-term outcomes that show value created or costs avoided to inform policy decisions, e.g. wellbeing, utilization, mental health and involvement with the criminal justice system
With an eye on the recently announced SIPPRA funding to conduct multi-year pay for success projects, Third Sector Capital offers up four tips for community organizations or their partners who are planning to explore these opportunities:
- Make use of existing data infrastructure: Existing administrative data is becoming commonly available, “thanks to the proliferation of integrated data systems and growing awareness of the value this strategic government asset can provide.”
- Include data for continuous improvement: Stakeholders should have access to the data needed to adjust and improve services throughout the project, and make sure to share payment metrics regularly to align work with the end goals.
- Design projects to answer critical policy questions: “To maximize the SIPPRA opportunity, policy metrics should answer questions that also cut across silos — for example, the links between behavioral health and benefits utilization, addiction recovery and family stability, or stable housing and workforce participation.”
- Elevate community voice: Community input is often left out of the picture, but strategic use of design-thinking principles and frameworks can be a tremendous value-add to help a project reach its intended goals.
Third Sector Capital offers several additional resources for community organizations considering applying for the SIPPRA funding opportunities in the months ahead. The Urban Institute has also compiled a lengthy list of resources to support interested parties, including an informative webinar.
