Funding the Future of Health Care

Stewart Hudson

Stewart Hudson, Executive Director of the Leon Lowenstein Foundation, sits down with Mollie Williams to discuss how foundations and individual donors can advance health equity and build stronger communities by supporting mobile health care delivery.

Mollie Williams: Stewart, the Leon Lowenstein Foundation has been operating since 1941 but only recently adopted a new focus for health grantmaking, pivoting your activities to better advance health equity. Tell us more about this shift and why the foundation is taking up this new course. 

Stewart Hudson: The Leon Lowenstein Foundation has been interested in healthcare since the foundation started, though the grantmaking support for providing health services has changed over the years. Recently, the board asked whether the foundation might be more impactful by looking at systems change, particularly related to the delivery of primary care. We eventually figured out that mobile health care does amazing things, including with the provision of both primary and preventive care especially for the people who need it most in rural and urban areas. We were surprised to note that there has, as yet, been very little foundation support for growing the field of mobile health care.

For these and other reasons, we are grateful to have moved into mobile health care delivery and become more impactful by looking at systems change that addresses health equity.

MW: Those in health care circles so often talk about our impact in macro terms, but it’s so powerful to hear stories from providers and those they serve at ground level – particularly, in mobile health care, where the impact isn’t just about treatments provided but in the relationships that are made. Can you recall any recent stories from the field that illustrate – in real, human terms – how inequities and disparities are addressed by mobile health clinics? 

SH: I recently had the opportunity to get onboard with The Family Van in Boston, and to see individuals being cared for by the team. What I was struck by is how much they depend on trust to feel confident in approaching the van and getting on the van and, frankly, in following through with what they learned about their own health needs when they received care on the van. 

It doesn’t take too much work to imagine that type of trust building on a broader scale. Of course, as a foundation we tend to think in those ways. But we always remind ourselves that this is about people – individual people. Whether it’s directly through getting on a van [to witness care being delivered] or through video recordings we get from some of our grantees or the news headlines that we see each and every day about new mobile clinics being created, we have a sense of the specific patient populations that are helped. We have a clear understanding that high-quality mobile care makes a huge difference in people’s lives, especially for those who are the most underserved. 

So, even though I would never profess to have the same connection with the patients and clients as the folks who work on the front lines in mobile health care delivery, I have a very real sense that what they do matters. It’s much needed and much appreciated by those they serve. 

MW: Mobile health clinics improve access to health services, especially for low- and moderate-income patients in rural and urban communities across the United States. Tell us about how the action plan for growing mobile health delivery, by doubling the number of mobile health clinics over the next five years (also known as 2x by 28), specifically tackles the access issue and please explain the goals of this initiative. 

SH: It’s part of our DNA at the Lowenstein Foundation to say that if you don’t have a goal that can organize or focus your efforts and inspire others to join in, then you’re not going to get to the destination you’re after. And our destination, together with others engaged in this effort, is to increase mobile health care delivery in rural and urban areas for millions of people. 

The way we convey that is to say we’ll double the number of clinics by 2028. That’s where 2x by 28 comes from. I do want to be clear that we also care about quality – so this goal is really a “more and better” approach.  

It is interesting to me that it has taken health experts, policy makers, and providers this long to realize how great a return of investment there is in mobile health care delivery.  We’d hear, in the past, that health care accountants would say that mobile health clinics “just don’t pencil out”. But a greater awareness of the social and economic benefits from more mobile delivery means that almost every day there’s a hospital system that wants to break beyond the four walls of healthcare delivery in rural and urban areas. 

In addition, the private sector is saying, “We’ve got to get into this.” And it’s not to increase profit margins to some stratospheric level. It’s because it makes business sense in another way. It helps the goodwill of business interests that provide mobile delivery either to address the needs of their customers but also as way to attract and retain talented staff and associates. 

And there’s another part of this: our country and the health system we’re all part of, needs it! Imagine the benefits of doubling mobile health care delivery in rural and urban areas within five years. You will increase patient visits by 7 to 10 million a year. Lower the frequency of ER visits. Increase worker productivity by enhancing patient health outcomes. And reduce the factors that are already stressing a health ecosystem in the U.S. that is already overburdened.    

Imagine the benefits of doubling mobile health care delivery in rural and urban areas within five years. You will increase patient visits by 7 to 10 million a year. Lower the frequency of ER visits. Increase worker productivity by enhancing patient health outcomes. And reduce the factors that are already stressing a health ecosystem in the U.S. that is already overburdened.    

Stewart Hudson

MW: Why should foundations, donors and other like-minded organizations consider supporting mobile health care delivery as an investment in the future of health care? 

SH: So many foundations are focused right now on health equity. Mobile health is one very important building block in addressing that. So, I think there’s an available menu, so to speak, for foundations that want to get involved. [And across the country] one of the biggest challenges we have now is access. We’re in a crisis. Hospitals are closing in rural areas. 100 hospitals closing in the last 10 years, and more at risk of closure. And there are other reasons why access is equally difficult in urban areas. 

MW: What’s your advice for foundations and funders interested in getting involved? 

SH: There are a variety of different ways that community foundations and donors can get involved. Mobile health care clinics are tailor-made for community foundations because the work is so place-based and the value of it is so obvious. There’s so much that is measurable about it because these clinics create so much data. I think every community foundation and charities like United Ways can ask themselves, what are we doing to invest in mobile health clinics as one element in addressing health equity concerns in our communities?  

In addition to foundations and charities, private donors, especially those who have donor-advised funds, can also get into the act and support the growth of mobile healthcare in ways that are meaningful. Donors will find that with charitable support for mobile clinics, you will have a really solid return on your philanthropic investment.   

Mollie Williams
, MPH, DrPH is Executive Director of The Family Van and Mobile Health Map and Lecturer of Global Health and Social Medicine at Harvard Medical School. In her free time, she enjoys spending time with her family, traveling, and textile arts.

Stewart Hudson is Executive Director of the Leon Lowenstein Foundation. The Leon Lowenstein Foundation (LLF) is a family foundation established in 1941 with a focus on health, education, and the environment.