Improving Business Practices

Business Acumen for Community-Based Organizations

What is the Business Acumen Initiative?

Health care in the United States is undergoing rapid change, which is having a major impact on community-based aging and disability organizations (CBOs). These organizations seek to meet the needs of older adults and people with disabilities, but resources can be scarce as these populations continue to grow.

ACL, with public and private partners, created its Business Acumen Initiative (BAI) to help aging and disability networks meet this challenge. Launched in 2012, the BAI aims to strengthen networks from the inside, building their business skills, enhancing their effectiveness, efficiency, and sustainability.

The BAI brings together practical resources, subject matter experts, and technical assistance to offer participants the best chance at success, regardless of federal funding changes. It also aids health care providers and payers in delivery system reform. The fundamental idea is this: when services from CBOs and health care entities are well integrated, consumers win. CBOs are critical because they provide day-to-day community supports, such as person-centered planning, transportation, information and assistance, independent living skills training, and more, that can help older adults and people with disabilities to enjoy better health and independence in communities of their choice.

How Business Acumen Helps

Medicaid, Medicare, Accountable Care Organizations (ACOs), private insurers, and other private pay models offer opportunities for CBOs to tap into new revenue streams outside of government grants. However, securing contracts with such payers – and performing effectively under them – requires thinking and operating differently.

To successfully participate in this environment, aging and disability organizations must understand critical business skills and be prepared to:

  • build relationships with health care providers and payers
  • price and bill for services
  • describe how services will generate return on investment and cost savings for payers
  • negotiate contracts
  • manage interoperable data systems
  • access electronic health records
  • report data to payers

How the BAI Works

ACL, in collaboration with private foundations and other national partners, provides aging and disability networks with the tools they need to successfully partner and contract with respect to delivery system reform. Public-private partnerships are a hallmark of both ACL’s approach to supporting the networks and the sustainability strategies for CBOs.

The goal of ACL’s work in this area is to help states and CBOs develop innovative business models that enable them to market their services, compete in a changing marketplace, ensure funding for services, and help payers achieve quality goals and cost savings. Since its inception, the BAI has approached this goal by two major means: learning collaboratives and grants.

About Learning Collaboratives

From 2013 to 2016, ACL convened two learning collaboratives composed of networks of CBOs interested in improving their business capacity. The goal for each of the 20 participating networks of CBOs was to secure at least one new contract with a health care provider or payer by the end of the collaboratives. Various training and technical assistance resources, including webinars, targeted business areas such as marketing, contracting, and pricing services.

The networks also engaged in peer-to-peer learning—exchanging experiences, innovative ideas, and promising practices for providing integrated care in a range of community settings. These exchanges occurred amongst the networks and with other communities and local agencies facing similar challenges.

By the end of the collaboratives, the networks executed 28 signed contracts with a variety of health care providers and payers including health plans, physician practices, accountable care organizations (ACOs), and hospitals.

About Business Acumen Grants

In 2012, ACL funded two grants to build the business capacity of aging and disability organizations for managed long-term services and support. In 2016, ACL continued to expand the BAI by issuing three-year grants to the National Association of States United for Aging and Disabilities (NASUAD) and the National Association of Area Agencies on Aging (n4a). The grantees are working together to build on accomplishments of ACL's work. They complement other publicly and privately funded technical assistance centers that work to build business capacity in their respective networks.

Business Acumen Fact Sheet and Case Studies

Check out these websites for more information and resources on business acumen:

2016 ACL Grants to Advance Business Acumen of State and Community-Based Organizations

Grants totaling $3.75 million over three years have been awarded to the National Association of States United for Aging and Disabilities (NASUAD) and the National Association of Area Agencies on Aging (n4a) to build business capacity in the aging and disability services networks. Both projects are working together to build on the previous accomplishments of ACL's business acumen work and to complement other publicly and privately funded technical assistance resource centers addressing this critical issue.

Business Acumen for Disability Organizations Grant

Administration on Intellectual and Developmental Disabilities (AIDD)
Projects of National Significance

Business Acumen for Disability Organizations

Award Date:
September 30, 2016

The project will build the capacity of community-based disability organizations (CBOs) to contract with integrated care and other health sector entities. Improving the ability of disability networks to act as active stakeholders in the development and implementation of integrated systems within their state, the grantee will build knowledge and provide training and technical assistance through a learning collaborative model. The project will have four primary objectives:

  1. Develop baseline knowledge of current community-based organizations (CBOs)
  2. Provide broad-based training and technical assistance for disability networks to build their capacity
  3. Convene and provide targeted technical assistance utilizing a learning collaborative model
  4. Engage integrated care organizations, managed care plans, and other health care entities regarding the needs of consumers and the roles of CBOs

With its partners NASUAD anticipates the following project outcomes:

  1. Increased knowledge of current CBO successes, challenges, needs, and promising practices
  2. Increased technical assistance and business acumen resources to support CBOs
  3. Increase in learning collaborative participants’ business capacity to engage with integrated care networks
  4. The improvement of health care entities’ awareness about the role CBOs can play in the health care system

Partners include: American Association on Health and Disabilities (AAHD), the American Network of Community Options and Resources (ANCOR), the Autistic Self Advocacy Network (ASAN), the National Association of State Directors of Developmental Disability Services (NASDDDS), the National Council on Independent Living (NCIL), the National Council on Aging (NCOA),the National Disability Rights Network (NDRN), the Community Living Policy Center at the University of California at San Francisco (UCSF), the Research and Training Center at University of Minnesota’s Institute on Community Integration, and Mercer Human Services Government Consulting.

National Association of States United for Aging and Disabilities
1201 15th St. NW, Suite 350
Washington, DC 20005
Phone: (202) 898-2578
Fax: (202) 898-2583

Grant Number
90DNBA 0001

Project Period

Project Amount
$750,000 per year

Martha A. Roherty, Executive Director
1201 15th Street, NW, Suite 350
Washington, D.C. 20005

AIDD Project Officer
Katherine Cargill-Willis
Phone: 202-795-7322

Learning Collaboratives for Advanced Business Acumen Skills Grant

Learning Collaboratives for Advanced Business Advanced Skills

Award Date:
September 30, 2016

The new grant awarded to n4a will provide more in-depth learning opportunities for CBOs. In coordination with other technical assistance providers and national resource centers, n4a will:

- Organize and conduct three to five topically-based learning collaboratives to address advanced business issues, such as continuous quality improvement, infrastructure and technology, generating and maintaining volume, data pooling, and more.

- Provide targeted technical assistance to networks of community-based aging and disability organizations.

- Advance knowledge and capture insights through the learning collaborative to incorporate into future curriculum for national dissemination.

n4a brings deep expertise in building business capacity among CBOs, including their National Aging and Disability Business Institute. Partners in the project are the American Society on Aging, Evidence-Based Leadership Council, Independent Living Research Utilization, National Council on Aging, Meals on Wheels America, Elder Services of the Merrimack Valley, and Partners in Care Foundation.

National Association of Area Agencies on Aging (n4a)
1730 Rhode Island Avenue, NW, Suite 1200
Washington, DC 20036
Phone: (202) 872-0888
Fax: (202) 872-0057

Grant Number

Project Period

Project Amount
$500,000 per year

Mary Kaschak, Deputy Director, Aging and Disability Business Institute
National Association of Area Agencies on Aging (n4a)

Project Officer
Lauren Solkowski
Phone: (202) 795-7440

2015 ACL Business Acumen Learning Collaborative

ACL selected 11 networks of community-based aging and disability organizations to participate in a learning collaborative and receive targeted technical assistance related to business acumen. Read the press release. A welcome webinar (slides: PDF, 1.02MB | transcript: PDF, 116KB) was held on February 10, 2015. Learn more about each of the selected networks from the following list of network profiles.

Site Profiles (2015–16)

From May 2013 to December 2014, ACL provided technical assistance to a pilot learning collaborative with nine networks of community-based organizations to assist them in marketing, contracting, and pricing services they provide to older adults and individuals with disabilities. Following are profiles of the selected networks, resources, and webinars that have resulted from the pilot collaborative.

Site Profiles (2013–14)

TIM Talks Webinar Archive

TIM TALKS: Business Acumen Webinar Series

The Administration for Community Living (ACL), Office of Nutrition and Health Promotion Programs (ONHPP), in collaboration with consultant Tim McNeill, hosts a Business Acumen webinar series entitled, TIM Talks.

Webinars feature discussions on various business acumen related topics in an inviting question and answer format. In addition to specific topics, participants always have the opportunity to ask any Business Acumen related questions during the webinar. We challenge you to stump Tim with your questions!

Contact Phantane Sprowls to be included on the invite list:

Past TIM TALKS Webinars

“Business Acumen Overview and Comprehensive Care for Joint Replacement”, April 12, 2016

“Where Do I Begin”, May 17, 2016

“Engaging Managed Care Organizations (MCOs)”, June 21, 2016

“Becoming a Medicare Provider”, July 19, 2016

“CMS Proposed Rule Changes and the Role of the CBO”, August 23, 2016

“Developing Meaningful Partnerships with Hospitals”, September 27, 2016

“Developing Meaningful partnerships with Physician Practices”, October 25, 2016

“Increased Reimbursement for Care Coordination and the Potential Impact on Community Based Organizations (CBOs)”, December 21, 2016

“Health IT Interoperability and the Community Based Organization (CBO)”, January 31, 2017

“Establishing CBO-Physician Collaborations to Implement Reimbursable Chronic Care Management Services”, March 30, 2017

“Developing the Business Case for Outsourcing Care Management to a Community Based Organization (CBO)”, May 31, 2017

“Chronic Care Management (CCM) - Moving from Planning to Implementation”, June 22, 2017

“Care Management – The Build vs Buy Discussion”, September 28, 2017

“The Role of Accreditation as a CBO Business Strategy Option”, November 15th, 2017


Last modified on 11/04/2021

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