Atlanta, GA

Atlanta is experiencing growing rates of chronic diseases, persistent disparities in health access and outcomes, and rising costs. To avoid many different health needs assessments being conducted by a variety of community stakeholders, members of the Atlanta Regional Collaborative for Health Improvement (ARCHI) came together to conduct a collective assessment of their regional health system.

With diverse member organizations—including hospitals, federally qualified health centers, behavioral health providers, public health providers, philanthropy, local governments, regional leaders, and the Centers for Disease Control and Prevention—the group recognized it could be a challenge to identify a shared set of priorities, even with the comprehensive health assessment data in hand. Should setting priorities and determining actions be left to individual institutions? Or could the various stakeholders address the challenges as a region?

During a series of public meetings, beginning in July 2012, ARCHI members began thinking about ways to improve the health of their community and the quality of their health system. After deciding to focus on Fulton and Dekalb counties, they worked rapidly to compile both quantitative and qualitative data and develop a useful portrait of their current health system. But data alone could not address some of the most critical questions: Where is the Atlanta health system headed? How can they better direct the course of change? Where is greatest leverage? What costs and trade-offs are involved if they pursue different courses of action? Who gets to decide the future?

To find answers, the ARCHI steering committee turned to ReThink Health, asking us to configure our Dynamics Model to represent key elements of the Atlanta health system. The committee then convened a workshop with the region’s key stakeholders—more than 80 in all, including county commissioners and health policy leaders—to highlight what would happen without action and to call upon that group to collectively create a better vision for Atlanta’s future.

Rethinking the Regional System for Health

The ReThink Health Dynamics Model allowed diverse teams from the region to systematically test different program strategies, exploring how their health system would likely respond to different policies, including health disparities, economic development, quality of care and the health of citizens. Budget constraints were a central part of their discussions, and their explorations with the Model allowed them to discover the importance of sustainable financing to ensure lasting impact and bring about their desired future. This large and disparate group of Atlanta-area residents ultimately used clicker technology to take a real-time vote about their preferred strategy—with 87% agreeing on one scenario. That scenario now guides the priorities of all the signatories to ARCHI.

Working with the ReThink Health modeling team helped ARCHI prioritize among different policies and program strategies, identifying those that were essential to achieving their desired impact, and those that could be delayed or reduced if budget constraints demanded without substantially undermining their aspirations. The Model helped give these leaders from different city institutions a common understanding about the dynamics of their health system, but above all allowed them to identify a common set of goals and commit to working toward them together.

ARCHI has created a Playbook that integrates the insights from the modeling into a comprehensive set of initiatives for the community that will be used to lay the groundwork for the work ahead. ARCHI continues to meet regularly to oversee the implementation of the work outlined in the Playbook and is now focusing on one region of Atlanta as an area for concentrated, collaborative action. The group continues to grow as additional organizational allies join the effort.