Business Acumen Initiative

A RESOURCE FOR COMPETING IN THE NEW MARKETPLACE

Health care in the United States is undergoing rapid change, which is 

having a major impact on aging and disability community-based 

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.

The Administration for Community Living (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 and enhancing their effectiveness, efficiency, and sustainability.

How Business Acumen Helps

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, training 

on independent living skills, and 

information and other assistance. 

These supports can help older adults 

and people with disabilities to enjoy 

better health and independence in 

communities of their choice.

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; and

 report data to 

payers.

Last Updated: July 2017

ACL.gov

ACL is an operating division of the 

U.S. Department of Health and Human Services.
BUSINESS ACUMEN INITIATIVE:

A RESOURCE FOR COMPETING IN THE NEW MARKETPLACE

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 in the 

area of 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 to 

achieve quality goals and cost savings. Since 

its inception, the BAI has approached this goal 

by two major means: learning collaboratives 

and grants.

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 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 signed 28 contracts with a 

variety of health care providers and 

payers including health plans, 

physician practices, accountable care 

organizations (ACOs), and hospitals. 

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). 

Last Updated: July 2017

ACL.gov

ACL is an operating division of the 

U.S. Department of Health and Human Services.
BUSINESS ACUMEN INITIATIVE:

A RESOURCE FOR COMPETING IN THE NEW MARKETPLACE

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 for Disability 

Organizations 

Awardee: NASUAD

Funding: $750,000 per year for 3 years

Objectives:

 Develop baseline and increase knowledge 

of CBOs

 Provide broad-based training and technical 

assistance for networks to build capacity

 Convene and provide targeted technical 

assistance utilizing a learning collaborative 

model

 Engage integrated care organizations, 

managed care plans, and other health care 

entities to improve awareness of consumer 

needs and the role CBOs can play in the 

health care system

Partners: 

American Association on Health and 

Disabilities, American Network of Community 

Options and Resources, Autistic Self 

Advocacy Network, National Association of 

State Directors of Developmental Disability 

Services, National Council on Independent 

Living, National Council on Aging, National 

Disability Rights Network, UCSF Community 

Living Policy Center, University of Minnesota’s 

Institute on Community Integration, Mercer 

Human Services Government Consulting

Learning Collaboratives for 

Advanced Business Acumen Skills

Awardee: n4a 

Funding: $500,000 per year for 3 years

Objectives:

 Capture lessons learned from trailblazers in 

the aging and disability networks 

 Partner with health care system leaders

 Address common challenges in business 

and partnership by sharing breakthrough 

strategies

 Develop a multi-pronged dissemination 

strategy to spread the learnings from the 

Advanced Learning Collaboratives to a 

broad network of CBOs and other key 

stakeholders

Partners: 

American Society on Aging, Elder Services of 

the Merrimack Valley/Healthy Living Center 

of Excellence, Evidence-Based Leadership 

Council, Independent Living Research 

Utilization, National Council on Aging, 

Meals on Wheels America, Partners in Care 

Foundation

Last Updated: July 2017

ACL.gov

ACL is an operating division of the 

U.S. Department of Health and Human Services.