“How small can I stay, while still driving big, transformative impact?” It’s an exciting question some social entrepreneurs are now asking themselves as they consider how to turn a good idea into a scalable solution.
Organizations–and their leaders–are faced daily with choices about how to use their time and energy, and experience real trade-offs between focusing those assets on the direct growth of their service or program or on strategies for wide-spread change, like driving shifts in public policy or building partnerships with established large institutions that can serve as distributors. Only the latter type of activity enables impact at scale, but to pursue it, organizations have to have built sufficient evidence of results and replicability via direct growth. The questions of how much direct growth, in what kinds of markets, with what kinds of populations, are complex. Social entrepreneurs who once might have responded “as much as possible, everywhere that’s possible” are now answering growth questions in more sophisticated ways that rebalance the direct growth and scaled impact equation.
I’m calling this new approach “smart growth”–the use of new design frameworks, access to data, and technology to create bigger, faster pathways to scale. It is one of the most intriguing opportunities we have for meeting the needs of millions across the nation who struggle with poverty, health problems, and lack of opportunity.
A great example of this thinking is Health Leads, a nonprofit organization that has a vision for a health care system that addresses all patients’ basic resource needs as a standard part of quality care, in order to improve health outcomes and lower costs. The organization, a New Profit partner and grantee, operates volunteer desks in health clinics to provide low-income patients with “prescriptions” for basic resources like food and heat, and guidance on programs they may be eligible for to improve their quality of life. Building on this link between health and poverty, Health Leads has grown from a small outpost at Boston Medical Center to a volunteer network covering seven metropolitan areas, where 15,000 patients and families benefited from Health Leads’ support last year. More than 75% percent of the organization’s 4,400 volunteer alums report working in poverty and health care–and of those, 54% work specifically with underserved populations, bringing with them this integrated perspective.
Health Leads has every reason to celebrate their growth, but the organization’s leaders remain focused on their mission to drive systemic change. Over the last few years, they’ve evolved their own views on growing their impact through a fresh lens, as explained here by cofounder and CEO Rebecca Onie:
“We learned that you can’t just do growth for growth’s sake. Health care is not about geography; it’s about institutions, so we developed a hypothesis that we could build a portfolio of health system partners and place our programs in those systems. We could then use our programs as a vehicle to engage the systems around taking up our approach to quality care, while hopefully making them national evangelists for this approach. All of a sudden, we saw that systemic change could happen.”
This thinking has led to some exciting action. Earlier this year, Health Leads announced a partnership with Kaiser Permanente, one of the nation’s largest health care providers, to roll out the integrated care approach in the company’s hospitals and clinics in California. Kaiser’s huge size and influence could help pull the entire health care system in a new direction if outcomes are strong. There are also risks relating to whether Health Leads’ true mission can remain intact in a profit-driven setting. Strong leadership and continued focus on accountability are the key ingredients for ensuring that social impact remains core to the partnership.
The Health Leads approach to smart growth is only one of many exciting social impact models that are popping up across the for-profit and nonprofit sectors in organizations both newer and well-established, where leaders are considering a fuller and more sophisticated array of pathways to scaled impact beyond direct growth of their organization’s core service or program. Here are some others to consider:
- Goodwill Industries: Under the leadership of Jim Gibbons, this venerable nonprofit retailer has transformed its 2,900-store network to advance its founding social mission and drive greater impact. Through its affiliates, Goodwill has added a greatly strengthened set of services for low-income customers, augmenting their offerings far beyond the donated goods it sells. Today, customers can tap into support on financial education, public assistance programs, and entrepreneurship at most locations. For an organization over 100 years old, Goodwill demonstrates an approach to growth and impact that is anything but stodgy and stuck in the past. The organization has signed up A-list corporate partners and created a community-building function called “The Donate Movement” that uses user-friendly technology to engage donors. Goodwill published its results for 2013, demonstrating the large transformation it’s had since the function was launched in 2010.
- Neighborhood Trust: This 20-year-old nonprofit organization works to combat financial disenfranchisement in New York City, where it serves some 6,000 low-income clients with financial empowerment and planning programs. Recently, Neighborhood Trust has launched two creative initiatives to strengthen and broaden impact. The first, The Trust Card Program “applies behavioral economic principles to create a socially responsible credit card product that provides access to credit only in proportion to a client’s demonstrated ability to manage and pay down debt.” The second, The Employer Solution brings Neighborhood Trust counseling into workplace settings through partnerships with companies. The whole idea is to build on Neighborhood Trust’s already-impressive impact in ways that drive large-scale results without adding big, unsustainable operational burdens.
- Wholesome Wave: This nonprofit organization has been a leader in connecting the healthy local food movement to low-income people with programs like the Double Value Coupon Program, which allows people to use Supplemental Nutrition Assistance Program (SNAP) benefits on fresh food. Now active in 25 states and more than 300 farmers markets and community health care settings, Wholesome Wave has shifted significant focus to policy advocacy that can help scale its local approach. The 2014 Farm Bill was signed into law earlier this year, including the Wholesome Wave-backed Food Insecurity Nutrition Incentive Program (FINIP), which provides $100 million in new funding for nutrition incentive programs like the organization’s pioneering coupon program.
These are just a few examples of organizations using operating model transformation, market-driven product development, partnerships, and policy advocacy to pursue impact at scale. Others are taking technology-focused approaches, a salient trend in social innovation that I will discuss in a future piece. Increasingly, old ways of thinking about growth in the nonprofit sector are being turned upside down, and a new story of impact is unfolding as a result.