Stewardship, Strategy, Ventures Leading with a Value Proposition: Making the Case for Change June 28th, 2017 Sherry Immediato Share Post Every day we are presented with cases for action. Most tell us we will be better off if we buy something, but some of those cases change our lives. “A mind is a terrible thing to waste,” “Make smoking history,” “There is no Planet B.” Each of these, and many others, have had staying power for me; they are tied to vivid and specific images and they’ve caused me and millions of others to change our behavior. Why are they so effective? Together, the phrase and images communicate a problem and present a benefit to taking action – both for individuals and for society as a whole. Because a response depends on our heads, our hearts, and our hands, the best cases for change are analytically compelling, emotionally engaging, and specific about what to do next. This isn’t so different from what we all ought to be doing when making a case for transforming our health ecosystem – whether a specific initiative, broad community change, or a national policy. At ReThink Health – where we are working with multi-sector partnerships that are trying to do just that – we talk about creating and communicating compelling value propositions that can make the case for change. Value propositions begin with a case for why change is important, describe the benefit and likely success of the strategies proposed, and end with a clear invitation to be part of the solution. Why Change is Important While we are quite good at short term goals, collaboration, and funding, significant improvements in health and equity require deep partnership among diverse stakeholders over decades. Perhaps because there are so many urgent needs, we’ve developed some habits skewed to the short term. We often rely on tales of woe, asking that others act out of the goodness of their hearts. We argue that action and investment should happen simply because it is the right thing to do. And after all, there is urgency because it’s an emergency! When our pitch works, we secure temporary relief but end up on a hamster wheel of recruiting support and funding. In the worst case, the appeal is effective at showing how bad the situation is – so effective that it backfires and stakeholders assume their time, money and strategic support are meaningless in light of how much effort and investment are really needed because our ask was for a band-aid to staunch a hemorrhage. What should we do differently in order to create strong value propositions that engage key stakeholders, promote alignment, and guide strategy to make transformation possible? What Makes for a Strong Value Proposition? There are three essential parts of a value proposition: There is a problem in need of a solution, or put another way, there’s a gap between aspirations (e.g. healthy kids) and reality (e.g. 50% are at risk for adverse experiences; 30% of middle schoolers report considering suicide). There are multiple dimensions to the value of closing this gap, recognizing that different stakeholders may perceive different value: the kids (well-being), families (stress reduction), educators (more teaching, less policing), providers (more preventive care, less urgent care), taxpayers (reduction in costs of educational interventions, more productive members of society) and citizens (equity, safety). There is a solution, and it has a high likelihood of success—therefore producing value for the community. (e.g. Training teachers and providing schools with the resources to treat the most challenging students results in improved mental health, school attendance, school outcomes, and ultimately breaking the cycle for the next generation). The following criteria can help evaluate a value proposition: The creative tension generated by the gap. No matter how big the gap, is there a story of hope? Is there an aspirational and compelling vision or goal? Is the view of reality realistic and fair, ideally with a systems explanation of what is causing the problem? Is it clear? The relevance and attractiveness of the value of closing the gap. Calculating value needs to be honest – it costs something to change, and to give up what you have. This has to be balanced against the expected gain. Is there enough of a gain to warrant change? Is there a way to share the pain and gain among the multiple stakeholders? The feasibility and credibility of the solution. Significant change typically requires a breakthrough. Simply doing more of what we did before is unlikely to produce a different result. A fresh approach needs to be logical in creatively addressing the cause of the problem and feel doable. What to Consider When Developing a Value Proposition There are many ways to develop a value proposition, but a few pitfalls can get in the way regardless of method. What can you do to counteract them? Favor involvement over efficiency: Anyone can craft and present a compelling value proposition. Approaching this as a solo, or even small group, task is rarely successful when multiple stakeholders will be required to implement it. Small groups should facilitate the process and do the necessary work to move it forward. But in order for a wide range of stakeholders to feel ownership of the value proposition, they will need to have helped author it. Focus on multiple aspects of value: Primary authors of value propositions tend to think that their view of value is the only view of value. Public health people will favor health outcomes; employers will focus on health care costs; providers may focus on efficiency. Each of these stakeholders needs to feel they will gain from the solution. Put a face on the problem, the solution, and the value: The most common criticism of value propositions is that they are too abstract. For example, it’s much more powerful to talk about reaching 100 pregnant moms than 10 percent of births. Marketers call this “social math.” Even better are stories of real people facing the problem and benefiting from the solution. Real people humanize the problem and demonstrate that a solution is possible. One great example of a value proposition embedded in a personal story is Stop Donating to the Homeless, a video from the Weingart Center. ReThink Health is working closely with all of its Ventures communities to develop strong and cogent value propositions. Among these is Common Ground Health, a multi-sector partnership in the Finger Lakes region of New York. For decades, Common Ground Health has supported a cross-sector planning and decision-making process that has played a part in the region’s dramatically lower healthcare costs with exceptional health outcomes. Stakeholders across the region—employers, citizens, providers, and government—all see benefit from the effort they have made to align around a common regional vision of keeping costs low and improving outcomes. Today, Common Ground Health is adapting to its changing environment and refining its value proposition—an adjustment that all transformation efforts should continue to undertake as the environment they work within shifts. Keep an eye on this blog as we dig deeper into the value proposition and – later this year – into other elements of transformation as well. The personal views and opinions expressed in this blog (and in any comments) are those of the original authors only, and do not reflect the opinions of The Rippel Foundation or ReThink Health. Neither The Rippel Foundation nor ReThink Health is responsible for the accuracy or validity of any of the information contained in the blog or any comments. All information is provided on an “as-is” basis. Join the Conversation Kitty Bailey I am so glad you called out “involvement over efficiency.” This involves its own creative tension as we balance our desire (and our funder’s desires) to achieve outcomes at scale versus the need to use an inclusive process very often driven by “community-time.” We are trying to strike this balance in San Diego through our Be There San Diego efforts. One struggle we face is the need for meaningful resident engagement, would love to see a post focused on how to effectively engage residents. Sherry Immediato Thanks for this comment, Kitty. We will definitely be posting more on overall stakeholder engagement and resident engagement in particular. A principle I try to adhere to is that our health improvement efforts should be done with rather than to or for others. There are all too many stories of well-intentioned efforts wasting resources solving the wrong problem. One way to think about an inclusive value proposition process is as a shared problem framing effort – are we trying to close the same gap? or event better, gaps? See a recent interview with MIT’s Nelson Repenning for more specifics on what it means to frame a problem well. https://www.inc.com/theodore-kinni/theres-one-question-you-must-ask-before-solving-any-problem-its-also-the-most-un.html Engaging those who have the problem (and there are many ways to define this beyond residents) builds commitment as well as intelligence with respect to the issue. I like Otto Scharmer’s story of bringing together a community around the issue of ambulance and emergency services in Germany. http://bit.ly/2spdv3w (Disclosure: I was the publisher of this piece.) Hope these help for now!