ReThink Health’s History

ReThink Health is the brainchild of a group of visionary leaders from multiple sectors. It’s grounded in the earliest thinking of The Rippel Foundation’s first President, Julius A. Rippel, who as far back as 1959 raised concerns about our unsustainable health care system and the need for new ways of thinking and acting to keep people healthy and health care affordable. After decades of grantmaking, it became apparent in 2007 that to achieve Rippel’s mission, a tectonic structural shift to the system that produces health and well-being would be necessary.

To figure out how to spark that change, Rippel convened a group of extraordinary leaders—those who would become ReThink Health’s pioneering founders. The group included some of the nation’s most respected health care leaders, as well as a diverse group of experts and change agents from economics, politics, business, community organizing, and energy. Putting their heads together between 2008 and 2010, they realized everyone would need to rethink their approach to improving health and well-being—and an entirely new kind initiative would be needed to help leaders across regions and sectors to see a new way forward. That initiative is ReThink Health. They based the initiative on the guiding principles that, to make lasting change to the health ecosystem, efforts must be:

  • Systemic Approach challenges from a system level and design a new system that fosters health and well-being.
  • Transformative Incremental change is not enough. Business-as-usual is not working, so we must upend the status quo and transform the system, all the way down to how people think about health and well-being.
  • Stewarded Leaders must be stewards—they must take responsibility for forming working relationships with others to transform health and well-being across their region.
  • Multisector Stewards must form relationships across sectors. Every part of a regional system contributes to health and well-being, so they must all be at the table, whether they are health care providers or payers, or they are focused on education, business, justice, and so on.
  • Regional Health and well-being are largely local, so system-wide national impact will build from local action. There is no one-size-fits-all solution.
  • Equitable The transformed system that produces health and well-being must be equitably designed and address systemic inequities in the current system, as those inequities are a major barrier to health and well-being for all.

Based on these pillars, the pioneers founded ReThink Health with the goal of gaining greater understanding of these ideas and spreading what is being learned about what it will take to transform the system that produces health and well-being. Some of ReThink Health’s most exciting discoveries since its founding include:

This “health system in a computer” is an interactive tool that allows stewards to explore how various strategies might impact their region’s health and well-being. Thousands of people and organizations have used the model to test different combinations of investments and interventions, informing their real-life strategies.

This Pathway is ReThink Health’s best hypothesis of what it takes to become stewards and transform together.

The Ventures project explored what could accelerate the progress of ambitious multisector partnerships working to transform health in their regions, and what often stands in the way of that progress. We worked with multisector partnerships in six regions across the country as they built practices that are essential for transforming a regional health ecosystem.

ReThink Health worked with multisector partnerships in Minnesota and Michigan to create maps of their regions’ health ecosystems, as part of their collaborative exploration of effective ways to intervene.

This workbook, divided into easy-to-digest modules, uses colorful examples, engaging exercises, and plain, everyday language to help stewards do what it takes to expand their financing horizons beyond the grant to more sustainable options.

Community Activation for Health System Transformation was a 5-year project focused on developing a set of skills stewards can use to train themselves and others to build coalitions, distribute stewardship mindsets across those coalitions, and build stewardship capacities among themselves and others. We forged and tested a curriculum for teaching these skills that had a major impact on a national workforce in the health care sector.

We developed a toolkit with exercises, meeting guides, videos, and more to help stewards plan resident engagement efforts. Among other things, the toolkit can help stewards accurately assess their resident engagement efforts, get on the same page about their goals, and figure out how to close the gap between the two. As part of this, we laid out a typology of the three outcomes (resident awareness and participation, feedback and input from residents, and active resident leadership) that stewards engaging in regional resident engagement practices seek to pursue, and the common practices they use to achieve those outcomes. Transforming a region’s system for health requires a balance between practices across all three outcomes.

With the National Academy of Medicine, we published a widely-read paper and designed a national meeting exploring how stewards might use tax credits as a means to fund population health efforts.
 The paper includes two detailed prototypes we developed to show how such a tax credit could work.

Our national survey, conducted in 2014 and 2016, sheds light on how stewards approach the work of transforming health and well-being in their regions, including how they advance and finance their efforts.

ReThink Health’s Pioneers
See some key accomplishments that led to each pioneer’s role in founding ReThink Health. These tremendously talented people continued to make marks in their respective fields, but the list below only features highlights from before they founded the initiative.
  • Donald Berwick
    Health care quality improvement
    Former head of the Centers for Medicare & Medicaid Services and the Institute for Healthcare Improvement. One of the country’s foremost advocates for advancing quality improvement and value-driven health care.
  • Elliott Fisher
    Health policy and research
    At the time, was director of The Dartmouth Institute for Health Policy & Clinical Practice. His research has shown how variations in health care spending have little to do with health status or price or outcomes, but rather on greater use of services.
  • Marshall Ganz
    Community organizing
    Harvard professor and community organizing luminary. Helped organize the United Farm Workers and supported development of President Obama’s winning campaign strategy.
  • Laura Landy
    Philanthropy and entrepreneurship
    Rippel president and CEO. An entrepreneur and foundation leader whose work has focused on bridging sound market and business practices with social goals to create sustainable solutions to our nation’s most challenging problems.
  • Amory Lovins
    Energy research
    A renowned scientist and founder of the Rocky Mountain Institute, whose critical thinking about alternative approaches to energy policy has driven world leaders and the public to think differently about climate change and sustainable energy.
  • James (Jay) Ogilvy
    Business (strategic planning)
    A cofounder of Global Business Network, who helped pioneer scenario planning, which has become an integral part of strategic thinking in business and government and has revolutionized both public and private planning.
  • Elinor Ostrom
    Economics
    A Nobel Laureate in Economic Sciences, whose research has been at the forefront of promoting policies for fostering democratic governance and sustainable stewardship of common resources shared among populations. Elinor passed away in 2012.
  • Peter Senge
    Organizational design and systems thinking
    A pioneer and influential leader in economic and organizational design, systems thinking, and leadership development, who founded the Society for Organizational Learning. His book The Fifth Discipline has been hailed as one of the most important management books ever by publications like Harvard Business Review and Financial Times.
  • John Sterman
    Environment and system dynamics
    An MIT professor and a leader in system dynamics, who has focused on addressing climate change and helping corporations see opportunities and consequences of their investments.
  • David Surrenda
    Organizational psychology
    A psychologist and founder of the Graduate School of Holistic Studies at John F. Kennedy University. David developed The Leadership Edge which helps leaders advance creative-change strategies and sustainable solutions for their organizations.