Not Only How Much But How: The Importance Of Diversifying Funding Streams In A Reimagined Public Health System

Health Affairs June 25, 2024
J. Mac McCullough, Umesh Ghimire, Jason M. Orr, Sezan O. Onal, Ashley Edmiston, Krishna Patel, Timothy C. McCall, Jonathon P. Leider

Abstract

Revenue diversification may be a synergistic strategy for transforming public health, yet few national or trend data are available. This study quantified and identified patterns in revenue diversification in public health before and during the COVID-19 pandemic. We used National Association of County and City Health Officials’ National Profile of Local Health Departments study data for 2013, 2016, 2019, and 2022 to calculate a yearly diversification index for local health departments. Respondents’ revenue portfolios changed fairly little between 2016 and 2022. Compared with less-diversified local health departments, well-diversified departments reported a balanced portfolio with local, state, federal, and clinical sources of revenue and higher per capita revenues. Less-diversified local health departments relied heavily on local sources and saw lower...

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