Collaboration in an Era of Seismic Market Shifts
What Idaho's 16-Organization Collaborative Teaches Us About Community Health Done Right
Healthcare has always been complex. But right now, the pace of change is different.
Between mergers & acquisitions, Medicaid overhauls through HB1, the Rural Health Transformation Program, and insurance changes leaving entire counties without coverage, the market forces reshaping healthcare aren't slowing down — and they're pushing health systems, local health departments, and community partners to collaborate in ways that are faster, deeper, and more accountable than ever before.
Metopio recently hosted a webinar with two of the people doing this work on the ground: Stephanie Stokes, Community Health Manager for Children's Health at Intermountain Health, and Angie Gribble, Senior Director of Community Health and Engagement at St. Luke's Health System in Idaho and Eastern Oregon. Together, they shared the story of the Western Idaho Community Health Collaborative (WICHC) — a 16-organization, 10-county collaborative that conducted Idaho's first-ever collaborative Community Health Needs Assessment in 2023.
There Are Three Things That Make Collaborations Actually Work
Here's what separates collaboratives that drive real action from ones that stall out after the assessment:
Financial investment: When organizations pool resources and have real skin in the game, commitment to action follows. It's that simple (and that difficult).
Trust: Not assumed trust, earned trust! And it only comes from making space for new partners, genuinely listening, and ensuring every voice at the table has equal weight.
Transparency and commitment to action: Communities have long memories. If all you do is assess and nothing changes, you lose their trust and then their participation — and it's very hard to get back. Being upfront about your non-negotiables, your resources, and your constraints from the beginning creates the conditions for real follow-through.
““Communities are quick to be vocal about that lack of action. Being able to respond together is really essential.””
The Idaho Story: What 16 Organizations Built Together
Founded in 2019, WICHC brought together 16 diverse members across a 10-county footprint in Southwest Idaho: health systems (including St. Luke's and Intermountain), public health districts, nonprofits, social services organizations, and even higher education with Boise State University at the table. Their mission was to transform community health through collaboration, shared prioritization, and a prevention-focused approach.
In 2023, they completed Idaho's first-ever collaborative CHNA — a shared assessment across all member organizations, working from a common data set, aligning resources toward the same health goals.
Their top priorities coming out of the assessment were housing, mental and behavioral health, and access to care.
If these sound familiar, that’s not surprising.
The Trouble with Big, Vague Priorities
"Access to care." "Mental health." "Housing."
It’s correct to call these out, they’re real needs. But named at this level, they can feel paralyzing — for collaboratives trying to figure out where to start, and for communities who don't see themselves in a plan that feels miles above their daily reality.
Historically, the response to broad priorities has been to lean into programs that already exist and activities already getting done, then tag them as addressing the named need.
As Angie said during our webinar, "Before, we weren't able to measure our effectiveness and impact... even though on paper we could say we were doing the thing."
The shift WICHC made — with Metopio as the data infrastructure — was to drill down. To ask not just "what are the needs?" but "what does this need look like, specifically, in this census tract, for this community?" That specificity is what turns a CHNA priority into a real action plan.
From Broad Need to Targeted Action: The Housing Example
The most concrete illustration of this came from WICHC's housing work with NeighborWorks Boise, a national affordable housing organization with resources for home repair programs.
NeighborWorks came to the table knowing housing was a WICHC priority. But they needed to know where to focus their limited resources. So WICHC and NeighborWorks used Metopio to drill into census-tract-level data, looking at three specific indicators:
Median year structures were built — where were the oldest homes?
Homes lacking kitchen facilities — where were the most significant gaps?
Homes lacking complete plumbing — where were quality and safety concerns highest?
One census tract kept surfacing across all three indicators, so that became the target.
Instead of spreading resources thin across an entire city or county, NeighborWorks could focus their home repair programs exactly where the data pointed — and build a foundation for measuring impact in future CHNA cycles.
What This Means for Your Collaborative
Whether you're in the early stages of building a collaborative or deep into your third CHNA cycle, WICHC's story offers a few practical takeaways:
Start with who's at the table (and who isn't): Defining your community before you define your methodology is the first step, one that often gets skipped.
Specificity is what makes a CHNA useful: Broad priorities are a starting point. Drilling into what those priorities look like at the census tract level — for your community, with your data — is what makes them actionable.
Trust takes intention: Especially when new partners are involved. Build in the time and the structures to earn it.
Don't let funding drive your work: Let the data drive the decisions, then find the funding to support it.
The relationships outlast the market: Even when organizations exit markets, the collaborative infrastructure, shared data, and trust persist.
Want to Learn More?
You can access the full webinar recording here.