Deciding Your Approach

What is your purpose or mission as a place-based, community investor?

It is important to identify your goals and motivations for pursuing place-based investment, as these will guide your process for designing and implementing a strategy. For example, are you pursuing place-based investment to:

  • More effectively address social determinants of health?
  • More effectively address imperatives identified in community health needs assessment reports?
  • Help fill a gap in the marketplace?
  • Expand resources for community economic development investment?
  • Improve corporate social responsibility?
  • Promote access to jobs, housing, food, arts/education, and healthcare among low-income and/or minority communities?
  • Understand the market ecosystem that serves your community?
  • Address a specific community need with a targeted intervention?
  • Another reason?

Summarize your goals as a place-based investor:


Advice from the Field:

Pablo Bravo, vice president of community health at Dignity Health, explained the primary purpose of their $100 million community loan fund:

“The board allocated a certain percentage of our investment portfolio to create a community investment program in order to improve factors upstream that impact health negatively. Our board decided this was a strategy to solve some of the healthcare issues in low-income communities determined by access to housing, job creation, safety, parks, healthy foods, and other social determinants of health…When organizations come to us, they come to us because they have a project that requires gap-financing that we may be able to fill. We also engage organizations to let them know if they take on certain projects, we are willing to provide capital.”1Pablo Bravo, phone interview by David Zuckerman and Katie Parker, March 18, 2016.

Developing your Strategy

Dignity Health’s approach to community investment has shifted from an initial focus on investment strategies and intermediaries to one that prioritizes identifying impact goals and specific themes, which in turn inform the strategies pursued. All of its investments are guided by key principles:

Key Principles Place-based Investment Themes Investment Vehicles
  • Target resources to low-income communities
  • Invest in the revitalization of urban or rural areas
  • Empower low-income people to create, manage, and own enterprises
  • Demonstrate a commitment to healthy communities
  • Safeguard the environment
  • Economic development
  • Affordable housing
  • Renewable energy
  • Arts and education
  • Alternatives to predatory lending
  • Healthcare access (community health centers/Federally Qualified Healthcare Centers)
  • Secured and unsecured debt
  • Line of credit
  • Loan guarantees
  • Linked deposits (credit unions and community banks)
  • Equity capital
  • Real assets


What key principles will guide you?

What place-based investment themes will you focus on?

What investment vehicles will you use?

Key Principles Place-based Investment Themes Investment Vehicles


How do your investment choices align with or promote the priorities outlined in your Community Health Needs Assessments? Your population health goals? Your sustainability goals? Your diversity and inclusion goals?

Tracking Dollars

Often the best place for a health system to begin the process of building a place-based investment program is by assessing its current asset allocation and investment choices.

Managing your Place-based Investment Portfolio

Designing your team and governance structure

Allocating Assets

How will assets be allocated from the investment portfolio for place-based investments?

Creating Forms and Templates

Hospitals and health systems have developed a variety of resources and materials to implement their place-based and community investment programs.

Moving to Impact

Communicating wins, building relationships, monitoring borrowers, and scaling impact


1 Pablo Bravo, phone interview by David Zuckerman and Katie Parker, March 18, 2016.