Dozens of funders contribute millions of dollars to health care initiatives in Michigan. But you might be surprised to learn how those funds are spent, and what funders would like to change about their own approach.

As part of our recent strategic planning process, the Michigan Health Endowment Fund set out to better understand philanthropic health care funding in Michigan. We wanted a clear picture of the sources, levels, and types of funding, as well as unmet needs and upcoming challenges.

Working with Public Sector Consultants and the Council of Michigan Foundations, we analyzed more than a hundred million dollars of grants awarded by 40 organizations over the past few years. We also met with representatives from fifteen Michigan foundations that fund some aspect of health care, from clinical research to service provision to policy reform. The resulting report, our Michigan Health Philanthropy Scan [pdf], provides valuable insight into the funding landscape across Michigan. Here’s how the numbers break down:

  • In the most recent two years of reported giving, the 40 examined foundations accounted for an estimated $160,910,160 in philanthropic contributions to health care—whether it be medical research, hospital operations, or other health-related programming.
  • This includes 769 separate grants of $25,000 or more to 378 programs, though the amount and scope of grants varied significantly within that total.
  • About half of the total funding available supported either medical research or hospital operations.
  • Out of $121,697,625 in non-research funding, about 30% supported programs intended to benefit children, while only 3% of the funding went to programs targeted at seniors.
  • Among grants dedicated to healthy eating/active living, $8,210,783 was directed toward programs specifically benefiting children and $784,875 toward programs benefiting seniors.
  • Of the $17,466,493 in behavioral health/developmental disability funding, we estimate that 20 percent is devoted to programs targeting mental, emotional, or cognitive disabilities and related counseling.

The most startling finding was the relatively small amount dedicated to programs supporting seniors. Michigan’s population is aging, and over the coming decades we’ll need to design innovative approaches to deliver more and better services to this population. Thanks to our legislative mandate in this area, the Health Fund is well-positioned to fill this gap and provide leadership in the funding community.

After all, philanthropy is not static. Foundations reevaluate their strategies and approaches; major legislation can solve old problems or create new ones; cultural, economic, and other factors change the context in which funders are working. With that in mind, we investigated not only current funding but also how changing circumstances might impact funding over the next several years.

The most dominant theme was the evolving impact of the Affordable Care Act, not only on the health care system but also on state-level policies. As providers, insurers, and governments adjust to meet the requirements and opportunities of the ACA, the needs of residents and nonprofit organizations are likely to shift as well. Other influential factors highlighted by experts included demographic shifts in the state as well as an increasing emphasis on population health and integrated care.

We also asked funders what specific health care issues they see as critical in the next several years, and whether grantmaking should focus on a particular group of people. Some of the most discussed issues were familiar: obesity and access, for example, were cited by multiple funders. But the top issue mentioned by funders was equity in health outcomes, a response that perhaps reflects a broader nonprofit focus on economic and racial equity. This response also underscores the need for foundations to more effectively track and measure their impacts.

For example, it’s relatively simple to report back on how many clinic visits we subsidized through a specific program. It’s a bit more complex, but still common, to estimate dollars saved by subsidizing preventative as opposed to emergency care. But it’s much harder to calculate how those clinic visits contributed (or didn’t) to better long-term health outcomes overall for seniors, low-income people, or minorities. Our study tells us that we must be ready to take on this challenge, and to use the results to guide our giving.

The good news about this tall order: we’re not in it alone. The funders we spoke with shared our appetite for collaboration, and recognized that systemic goals (such as addressing root causes and focusing on equitable outcomes) provide fertile ground for new partnerships.

We’ll continue using the report’s findings to shape initiatives that make a meaningful difference in the lives of Michigan’s residents. In the mean time, we invite you to view the entire report [PDF] for more detailed information and analysis.

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