Expanding access to care and supporting whole-person health is essential to reducing the cost of healthcare. While clinical innovation plays an important role, long-term health outcomes are often shaped by community-based services such as mental health support, housing organizations, food access programs, and transportation assistance that help people navigate care and stay healthy. When these services are available, they simplify the healthcare journey, reduce costly emergency visits, and help ensure people receive the right care, at the right time, and in the right setting. Yet many of these organizations have limited funding and struggle to secure the resources they need to continue their work and expand their services.
As more people face chronic conditions and rely on prescription drugs, lowering healthcare costs and improving the care experience requires a broader focus on coordinated and personalized care.
Identifying innovative solutions
What if we could use mission-driven funding to both expand access to programs that support health-related social needs and help community organizations stay financially strong?
That idea inspired a $10 million impact investing initiative, launched by the Elevance Health Foundation in 2024. Designed to complement traditional grantmaking, the program provides flexible financing that helps small businesses, nonprofits, and social enterprises expand their reach and capacity in ways that make care more accessible for the communities they serve. More than a year later, funds have been invested in community-based and purpose-driven organizations that tackle unmet health-related social needs across California, Texas, and Georgia.
As impact investing continues to grow, it is becoming a powerful way to expand access to care and support whole health, which helps lower healthcare costs over time. One important focus is helping the “missing middle.” These are organizations that are too large for small microloans but too small or too new to qualify for traditional bank loans. Many of these early- and growth-stage businesses serve important community needs but lack the flexible funding they need to grow. By offering financing that does not rely only on credit scores or personal guarantees, impact investing can help these organizations expand services in high-need areas such as behavioral health, services for individuals with physical disabilities or health challenges, and maternal health.
Strengthening these community partners can help address gaps in care before they lead to higher downstream costs, creating a more coordinated system of support that is both financially sustainable and easier for people to navigate.
Expanding beyond traditional philanthropy
Traditional philanthropy remains important but grants alone often do not provide the funding organizations need to grow and stay strong over time. Impact investing helps nonprofits and small businesses expand by giving them the capital they need to hire staff, improve their facilities, or manage debt. When those funds are repaid, they can be reinvested to support other organizations, creating a cycle of reinvestment that strengthens communities over time.
Across the country, organizations are demonstrating how access to flexible capital can expand services and improve the care experience. Examples include:
- A nonprofit in Texas received an impact investment to fund the creation of a new birthing center, expanding access to holistic, evidence-based maternal care and bringing services closer to families.
- In California, a nonprofit therapy center is using impact investment funds to upgrade its facility to continue delivering physical therapy, specialized fitness, and wellness programs to improve independence and quality of life for seniors and individuals with severe disabilities.
- In Georgia, a for-profit community wellness organization is applying funding to hire additional staff, enabling it to reach more adults, teens, and children with evidence-based therapy for anxiety, depression, and neurodevelopmental differences.
Each of these examples reflects a simple but powerful idea: when communities have the resources to design and sustain their own solutions, access to care improves.
The opportunity for foundations focused on health
Foundations committed to improving health outcomes have an opportunity to leverage funds in ways that both expand access to care and strengthen small businesses and nonprofits rooted in their communities. Investing in these organizations can help reduce barriers to care while building local economic stability and resilience.
Impact investing is not a replacement for traditional philanthropy; it is an evolution of it. As healthcare organizations continue to seek solutions that lower healthcare costs and improve consumer experience, community‑based impact investing offers a compelling model for how foundations can lead – strengthening communities, simplifying care, and helping build a more sustainable and equitable healthcare system.
Shantanu Agrawal, MD, MPhil, serves as chief health officer at Elevance Health and Mark Kaye serves as executive vice president and chief financial officer at Elevance Health
At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.