Anchor Institutions

Hospital Community Benefits after the ACA

Cynthia H. Woodcock and Gayle D. Nelson

Leveraging hospital community benefit policy to improve community health

A Case to End US Hunger Using Collaboration to Improve Population Health

Randy Oostra

Over the last 50 years, every U.S. president has worked, in some fashion, to address healthcare spending while improving the fundamental healthcare conditions for those in need. As healthcare leaders we often think in terms of three- to ve-year plans. But if we think about the next 50 years, it brings into question ‘what’ and ‘how’ the investments we’re making now in our communities — whether new facilities, programs or initiatives — will impact the public by 2064. 

Diversity in Health Care: Examples from the Field

Health Research & Educational Trust

Diversity is becoming a key word in health care. Hospitals and health care systems are focusing on providing care that addresses the diversity of their patient populations. To better care for diverse patient populations, hospitals are working to increase the diversity of their leadership team, board and staff. And many hospital teams are building a culture of diversity and inclusion, to better engage all employees and provide high-quality, equitable care for all patients. 

Diversity in Health Care: Examples from the Field

Health Research & Educational Trust

Diversity is becoming a key word in health care. Hospitals and health care systems are focusing on providing care that addresses the diversity of their patient populations. To better care for diverse patient populations, hospitals are working to increase the diversity of their leadership team, board and staff. And many hospital teams are building a culture of diversity and inclusion, to better engage all employees and provide high-quality, equitable care for all patients. 

How 3 CEOs Are Embracing Their Institutions' Roles as Anchors in the Community

Matt O'Connor

As integral parts of the community, health systems are in a powerful position to further social change.

The Role of Anchor Institutions in Restoring Neighborhoods

Janet Viveiros and Lisa Sturtevant
Anchor institutions, such as hospitals and universities, can be important catalysts for urban economic and community development. They can take on a variety of roles—from community infrastructure builder to purchaser of local goods and services to developer of real estate. With the passage of the Affordable Care Act (ACA), nonprofit hospitals and other health care institutions have new obligations and opportunities to embrace their role as community anchors by pursuing activities that focus on addressing the comprehensive health needs in their communities. In the years to come, health care institutions can become more actively involved in supporting the development of safe, decent and affordable housing, a key social determinant of health. This brief describes those opportunities and provides specific guidance for how affordable housing and community development organizations can successfully partner with anchor institutions to improve neighborhoods and expand housing opportunities.

Hospitals Aligned for Healthy Communities: Inclusive, Local Hiring

David Zuckerman and Katie Parker

Every day, we learn more about how patients’ health outcomes are tied not only to the healthcare they receive but also to the conditions in the communities where they live. Social and economic inequities, amplified by race, often emerge as the leading factors explaining differences in health outcomes and life expectancies.

Through local and inclusive hiring, health systems can invest in an ecosystem of success that lifts up local residents; helps create career pathways for low-income, minority, and hard-to-employ populations; and begins to transform neighborhoods. In the process, health systems can develop a more efficient workforce pipeline, meet sustainability and inclusion goals, and ultimately improve the health of their communities. Establishing a local and inclusive hiring strategy is an important first step towards rethinking your health system’s role in the community. This toolkit can help you get started.

UNM Health Sciences launches 'hire local, buy local' initiative to boost economy

The University of New Mexico Health Sciences Center, with the support of The Democracy Collaborative, initiated the Healthy Neighborhoods Albuquerque initiative to spur local economic development. The initiative includes growing local jobs, supporting local agriculture and providing better access to healthy foods. Read more about UNM Health Sciences launches 'hire local, buy local' initiative to boost economy...

ABQ hospitals behind initiative to hire, buy and develop local

Marissa Higdon
Albuquerque Business First

This article highlights an exciting partnership developing in Albuquerque, New Mexico among universities, hospitals, and local government that will help align healthcare institutions' resources toward community local hiring and sourcing. The inspiration for this alliance lies in Cleveland, Ohio with the Evergreen Cooperatives, a group of worker cooperatives pioneered by The Democracy Collaborative in the effort to democratize the local economy:

Hospitals lead ‘Healthy Neighborhoods’ initiative

Jessica Dyer
Albuquerque Journal

Several large anchor institutions in Albuquerque, New Mexico have adopted the local procurement practices pioneered in Cleveland, Ohio by The Democracy Collaborative and the Evergreen Cooperatives, helping galvanize the hospitals' resources and purchasing power to redirect wealth and health toward the community:

New initiative provides tools for health systems to re-invest in impoverished communities

Steven Ross Johnson
Modern Healthcare

The Democracy Collaborative's initiative to align hospitals in an effort to improve community health by increasing local hiring practices is taking root in Albuquerque, New Mexico, as the city engages with a team of large healthcare institutions committed to promoting and utilizing the strategies in the toolkits released as part of the initiative:

Healthy Neighborhoods Albuquerque aims to create Main Street jobs

Michael Haederle
University of New Mexico Health Sciences Center Newsbeat

This article details how The University of New Mexico Health Sciences Center, with the help of The Democracy Collaborative, is leading anchor institutions commit to buy local and hire local to improve community health in their surrounding neighborhoods in Albuquerque:

Strong City Baltimore

Founded in 1969 as the Greater Homewood Corporation, Strong City Baltimore adopted its new name in 2015 to reflect the organization’s evolution to a nonprofit focused on ensuring a stronger, more prosperous Baltimore for all city residents.  With a mission to build and strengthen neighborhoods, Strong City runs a range of programs aimed to ensure safe streets, desirable and diverse housing stock, quality public schools, a robust and educated workforce, and strong civic engagement.  In January 2016, the nonprofit launched a Community Wealth Building program, which is working at the city level to promote community wealth building strategies and models, and at the neighborhood level to catalyze concrete projects designed to build and grow neighborhood-based wealth.


HopkinsLocal is an initiative launched by Johns Hopkins University and Health System to leverage its role as the largest anchor institution in Baltimore and create economic opportunities in the city.  The initiative has three core goals:  1) to expand the participation of local and minority-owned businesses in construction projects; 2) to hire more city residents, particularly those from neighborhoods most in need of job opportunities; and 3) to increase procurement from local firms.  HopkinsLocal inspired 25 area businesses to initiate a similar effort, BLocal, which also aims to boost locally-based hiring, procurement, and construction contracting.  As of 2016, BLocal participants had pledged to direct at least $69 million into local and minority-owned, women-owned, and disadvantaged businesses over a three-year period.

Bon Secours

Established in 1919, Bon Secours is a 125-bed health facility in Southwest Baltimore with 860 employees.  Since the 1990s, Bon Secours has taken an active role in neighborhood revitalization efforts, developing 529 units of senior housing and nearly 200 units of family housing as of 2015.  Committed to the community, the hospital also supports a separate nonprofit, Bon Secours Community Works (BSCW), which provides a range of community and economic development programs, including workforce development, adult education, childcare, money management, re-entry services, and counseling.  Focused on asset building, BSCW runs Our Money Place, which provides free or low-cost financial planning, tax preparation, credit and debt counseling, budget preparation and management, public benefits screening, and eviction prevention services.  The nonprofit also includes a social enterprise, Clean and Green Landscaping, which provides training and job opportunities to area residents as they work to beautify and maintain vacant lots within the community.

Baltimore Integration Partnership (BIP)

Launched in 2011 as part of the national Living Cities Integration Initiative, Baltimore Integration Partnership (BIP) is a collaborative partnership between 11 educational and healthcare institutions (anchor institutions), funders, nonprofits and public organizations focused on ensuring economic inclusion is the “culture of norm” in Baltimore through local hiring, purchasing, and community reinvestment.  Its work is credited with helping 15 development projects secure debt financing, leveraging $150 million in investment and creating 800 jobs.  Currently, BIP is focused on three core goals:  1) to connect local, small and minority-owned businesses to anchor procurement opportunities; 2) to encourage and leverage the real estate investments of anchors for the benefit of the broader community; and 3) to connect low-income people to jobs within anchors and anchor-supporting businesses.

Parkland Health & Hospital System

Established in 1894, Parkland Health & Hospital System is now one of the largest public hospital systems in the country, with more than 10,000 employees and over 1 million patients per year.  Committed to sustainability, the hospital has an in-house laundry that relies on a water reclamation system, saving 1 million gallons of water each month. It also runs numerous programs to promote reuse and recycling.  In 2015, Parkland partnered with the City and UT Southwestern to publish a recycling framework that helps other medical institutions adopt more eco-friendly practices.  Also committed to supplier diversity, Parkland strives to engage woman and minority-owned businesses at all levels of its supply chain.

Dallas County Community College District (DCCCD)

Dallas County Community College District (DCCCD) is one of the largest community college systems in Texas, employing more than 7,000 people, and serving more than 3 million people since its establishment in 1965.  DCCCD estimates that more than half of its nearly $150 million a year budget for supplies and services is spent in Dallas County.  With a mission to ensure Dallas County is vibrant, growing, and economically stable for future generations, DCCCD also offers numerous free training programs, including skills building for small business owners, one-on-one financial counseling and money management classes for current students, and workforce development for people 16 or over who lack the basic skills needed for college or career success.

Cleveland’s Greater University Circle Initiative: An Anchor-Based Strategy for Change

Walter Wright, Kathryn W. Hexter and Nick Downer

Cities are increasingly turning to their “anchor” institutions as drivers of economic development, harnessing the power of these major economic players to benefit the neighborhoods where they are rooted. This is especially true for cities that are struggling with widespread poverty and disinvestment. Urban anchors— typically hospitals and universities—have sometimes isolated themselves from the poor and struggling neighborhoods that surround them. But this is changing. Since the late 1990s, as population, jobs, and investment have migrated outward, these “rooted in place” institutions are becoming a key to the long, hard work of revitalization. In Cleveland, the Greater University Circle Initiative is a unique, multi-stakeholder initiative with a ten-year track record. What is the “secret sauce” that keeps this effort together?

The Center on Wisconsin Strategy (COWS)

The Center on Wisconsin Strategy (COWS) is a research and policy center dedicated to improving economic performance and living standards in the state of Wisconsin and nationally.  Based at the University of Wisconsin-Madison, COWS promotes “high-road” strategies that support living wages, environmental sustainability, innovative local polices, and community wealth building. Read more about The Center on Wisconsin Strategy (COWS)...