The Brookings Institution’s Braiding and Blending Working Group is part of an ongoing project at Brookings focusing on encouraging cross-sector collaboration to improve community health and economic mobility. The purpose of the Braiding and Blending Working Group is to explore flexible funding strategies and ways in which the policy environment can be modified to achieve better health and social outcomes. You can access more on the Brookings Health-Economic Mobility project here: https://www.brookings.edu/series/building-healthy-neighborhoods/
Related Resources
White House Office on Children & Youth. Nemours Children’s Health.
NASHP Hospital Cost Calculator. (April 2022). National Academy for State Health Policy.
Summary of State Actions: Medicaid & Housing Services policy brief. (Feb. 2022). Corporation for Supportive Housing.
Equitable Economic and Community Development Policy Guide. (2021). Well Being in the Nation Network.
The Cradle-to-Career Guide to Federal Relief Funding for Kids During and Beyond COVID-19. (March 2021). Children’s Funding Project.
Health System Investments in Housing: A Development Guide. (Oct. 2020). Corporation for Supportive Housing.
Urban Institute’s Pay for Success Initiative (PFSI)
The Urban Institute’s Pay for Success Initiative (PFSI) serves as a knowledge intermediary for pay for success (PFS) projects at all stages of development and implementation. Urban’s team of experts works directly with government stakeholders, practitioners, and thought leaders to ensure that emerging PFS projects are grounded in the best available evidence and developed according to current best practices.
Collaborative Approach to Public Good Investments (CAPGI): A Feasibility Study
Purpose: To teach how a variation of an economic model and attendant processes might enable sustainable investments in upstream services that would benefit patients, stakeholders, and communities alike, and to assess the local conditions that make its implementation more or less likely.
- 1st Webinar: A Feasibility Study Overview – July 11, 2019 (Slides and Video)
- 2nd Webinar: Governance – July 24, 2019 (Slides and Video)
- 3rd Webinar: Data Requirements – September 12, 2019 (Slides and Video)
- 4th Webinar: Bidding, Pricing, and Reconciliation – September 25, 2019 (Slides and Video)
McKillop, Matt & Vinu Ilakkuvan. (April 2019). The Impact of Chronic Underfunding on America’s Public Health System: Trends, Risks, and Recommendations, 2019. Trust for America’s Health.
Toolkit: Upstream Health Priorities for New Governors. (December 2018). The National Academy for State Health Policy (NASHP) and the de Beaumont Foundation.
De Biasi, Anne & Vinu Ilakkuvan. (September 2018). Braiding and Blending Funds to Support Community Health Improvement: A Compendium of Resources and Examples. Trust for America’s Health.
De Biasi, Anne; Ilakkuvan, Vinu; & Naomi Seiler. (September 2018). Promoting Effectiveness and Sustainability of Initiatives to Improve Health and Social Outcomes: Methods that Federal Agencies Can Use to Facilitate Coordination and Integration of Funding Streams. Trust for America’s Health.
M. Nichols, Len & Lauren A. Taylor. (2018). Social Determinants As Public Goods: A New Approach To Financing Key Investments In Healthy Communities. Health Affairs. 37. 1223-1230. 10.1377/hlthaff.2018.0039.
Butler, Stuart. (August 2018). How “Wrong Pockets” Hurt Health. JAMA Forum.
Health Equity Zones: Building healthy and resilient communities across Rhode Island. (August 2018). Rhode Island Department of Health.
Blending, Braiding, and Block-Granting Funds for Public Health and Prevention: Implications for States. (December 2017). National Academy for State Health Policy.
Clary, Amy. (December 2017). Lessons from Rhode Island: How to Effectively Blend, Braid, and Use Block Grant Funds to Improve Public Health. National Academy for State Health Policy.
Kohli, Jitinder & Anne De Biasi. (August 2017). Supporting healthy communities: How rethinking the funding approach can break down silos and promote health and health equity. Deloitte University Press.
Clary, Amy & Trish Riley. (February 2016). Braiding & Blending Funding Streams to Meet the Health-Related Social Needs of Low-Income Persons: Considerations for State Health Policymakers. National Academy for State Health Policy.
Crawford, Maia & Rob Houston. (February 2015). State Payment and Financing Models to Promote Health and Social Service Integration. Center for Health Care Strategies.
Blended and Braided Funding: A Guide for Policy Makers and Practitioners. (December 2014). Association of Government Accountants.
Latest Research & Publications
- Ogburn, Joshua; Counts, Nathaniel; Dear, Annie. Improving Federal Policy for America’s Children. (May 2022). Social Finance.
- Butler, Stuart M.; Maguire, Marcella. Building connective tissue for effective housing-health initiatives. (May 2022). Brookings Institution.
- Polis, Sue; Kozlova, Olga. Transforming Systems to Improve Health. (March 2022). National League of Cities.
- Policy Brief: Summary of State Action Medicaid & Housing Services. (February 2022). Corporation for Supportive Housing.
- Map: Medicaid and Housing Related Services. (February 2022). Corporation for Supportive Housing.
- Lead Poisoning Prevention Fund: A Simple Solution to End Childhood Lead Poisoning and Promote Equity. (October 2021). Green and Healthy Homes Initiative (GHHI).
- Butler, Stuart M.; Higashi, Timothy. The COVID-19 experience shows government budgeting can become more nimble (May 2021). Brookings Institution.
- Butler, Stuart M.; Sheriff, Nehath. How the LINC to Address Social Needs Act can improve coordination of health care and social services (April 2021). Brookings Institution.
- Feldman, Andrew; Stack, Kathy. It’s Time to Fix the Frayed Relationships Feds Have With States and Localities. (October 2020). Government Executive.
- Butler, Stuart M. After COVID-19—Thinking Differently About Running the Health Care System. (April 2020). JAMA Forum.
- Navigating New and Flexible Funding Streams for Kids during COVID-19. (April 2020). Children’s Funding Project.
- Butler, Stuart M.; Higashi, Timothy; Cabello, Marcela. Budgeting to promote social objectives—a primer on braiding and blending. (April 2020). Brookings Institution.
- Riley, Trish; Clary, Amy; and Elinor Higgins. Identifying Gaps in Federal Oversight of Hospitals’ Community Benefit Investments – Opportunities for State Policy. (December 2019). The National Academy for State Health Policy (NASHP).
- Butler, Stuart M. New Budgeting Tools Will Help Foster Social Determinants of Health. (November 2019). JAMA Forum.
- Butler, Stuart M. How private sector tools can enhance governmental cooperation. (July 2019). Brookings Institution.
- Establishing a Local Wellness Fund: Early Lessons from The California Accountable Communities for Health Initiative. (July 2019). California Accountable Communities for Health Initiative (CACHI).
Important Legislation
- Social Determinants Accelerator Act – “This bill establishes the Social Determinants Accelerator Interagency Council and a grant program to address social determinants of health. These are nonmedical factors that influence health outcomes, such as income, educational attainment, and place of residence.” (Congress.gov)
- LINC to Address Social Needs Act – “This bill requires the Department of Health and Human Services (HHS) to award grants to better integrate health care and social services using technology platforms and related infrastructure.” (Congress.gov)
Webinars
Policymakers and health care professionals recognize that there is much more to good health than just medical care. Achieving healthy families and communities often requires us to address housing, social services, transportation, and other “social determinants of health.” For that to happen, there must be a collaboration between managers in different sectors, with program funds planned and used jointly. In this webinar briefing, Brookings senior fellow Stuart Butler is joined by three veteran health budget experts to explain the challenges of “braiding and blending” funds from different sectors and agencies, and the braiding and blending techniques used at different levels of government. Click here to learn more about this event here.
- CAPGI Webinar – The Role of Trusted Brokers. (Sept. 2021). Urban Institute.
Recent Events
Braiding and Blending Funds to Promote Social Determinants of Health
On May 1, 2019, the Brookings Institution’s Braiding and Blending Working Group hosted an event on how to establish more flexible funding strategies to improve community health and economic mobility. The event began with an introduction to the topic of “braiding and blending” funds from different sources and the challenges of achieving such flexible funding. A panel then deepened the conversation by providing examples and lessons from governments and organizations in the field. A second panel discussion assessed policy steps that could be taken to facilitate a better environment for addressing the challenges and opportunities associated with braiding and blending funds
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Welcome and introduction, Panel 1: What is Braiding & Blending & Why Is It Important? |
Panel 2: Organizations Currently Engaged in Flexible Budgeting |
Panel 3: Innovative Policy Steps to Support Braiding & Blending of Funds |
Blog Series
As part of this project, the working group collaborated with the Urban Institute’s Pay for Success Initiative (PFSI) to release a blog series on Uniting funding streams for health and social innovation. Though not every post is focused on pay for success, the working group and this blog series aligns with the PFSI mission of researching and supporting innovative financing solutions to today’s most pressing challenges. This series highlights the research of experts in health care financing focused on creative approaches.
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Braiding and blending: managing multiple funds to improve health Marcela Cabello, The Brookings Institution, and Katrina Ballard, Urban Institute September 17, 2018 |
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Making braiding easier: what can federal agencies do? Anne de Biasi and Vinu Ilakkuvan, Trust for America’s Health September 20, 2018 |
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A new way of solving an old problem: underinvestment in social determinants of health Len M. Nichols, George Mason University, and Lauren A. Taylor, Harvard University September 25, 2018 |
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Braiding federal funds to scale evidence-based solutions for families battling opioid use Kathy Stack, formerly at the Office of Management and Budget, and Matthew Eldridge, Urban Institute September 27, 2018 |
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Examples of braiding and blending to support community health: a compendium of resources Vinu Ilakkuvan and Anne de Biasi, Trust for America’s Health October 3, 2018 |
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Integrated funding streams across the health and human services continuum Ann Flagg and Christina Becker, American Public Human Services Association (APHSA) October 4, 2018 |
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An antidote to the “wrong pockets” problem? Stuart Butler and Marcela Cabello, The Brookings Institution October 8, 2018 |
About Us
Brookings Braiding & Blending Working Group
Stuart M. Butler, Brookings Institution
Anne De Biasi, Health Policy Consultant
Ann Flagg, American Public Human Services Association (APHSA)
Elizabeth Gaines, Children’s Funding Project
Marcella Maguire, Corporation for Supportive Housing
Len Nichols, Urban Institute
Joshua Ogburn, Nemours
Melissa Quick, Aligning for Health
Nehath Sheriff, Brookings Institution
Kathy Stack, KB Stack Consulting
Amelia Vaughn, Children’s Funding Project
Kelly Walsh, Urban Institute
Mary Ellen Wiggins, The Forum for Youth Investment
Sandra Wilkniss, National Academy for State Health Policy