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Earn and Sustain Stakeholder Buy-In

What is this and why does it matter?

Stakeholder buy-in means active commitment—not passive agreement—from everyone involved in a health equity initiative. Without it, initiatives risk resistance, resource gaps, and failure to integrate into existing systems.

Buy-in must be secured at every level:

Secure buy-in before launching your initiative and continue reinforcing it over time. If your team encounters resistance or disengagement, revisit your buy-in strategies—especially with leadership and frontline staff—to realign and move forward effectively.

How should you work through this component?

Begin with the Earning and Sustaining Stakeholder Buy-In Base Deck, which covers strategies for building and maintaining stakeholder commitment—including how to craft targeted messages, anticipate concerns, and tailor engagement approaches for staff, leadership, providers, frontline workers, and community partners. It also introduces the Spreading Your Message tool to support effective communication.

Then work through the following resources:

Curriculum to be complete for this component:

Earning and Sustaining Stakeholder Buy-In (Base Deck-Presentation)

Strategies for building and maintaining stakeholder commitment—including crafting targeted messages, anticipating concerns, and tailoring engagement for staff, leadership, providers, and community partners. Introduces the Spreading Your Message tool to support effective communication.

RIC – EE – EMSB – Earning and Sustaining Buy-In PPT 6.2025Download

Spreading Your Message Tool

A structured worksheet that helps teams craft targeted key messages for each stakeholder audience—anticipating their concerns and selecting the right delivery mode. Includes a guided table for message development and prompts for drafting communications across formats such as email, presentations, and outreach letters.

RIC – EE – EMSB – Spreading Your Message Tool 6.2025Download

Stakeholder Assessment Tool

A three-exercise tool for identifying key stakeholders, mapping their relationships and influence, and developing tailored action plans to earn and sustain their buy-in throughout the initiative.

RIC – EE – EMSB – Stakeholder Assessment Tool 6.2025Download

Cultures of Equity Example (Presentation)

A real-world example presentation, originally used by an MCO to build executive leadership buy-in, that defines health equity, makes the case for urgent action, and outlines strategies for creating an organizational culture of equity—adaptable for your own leadership engagement efforts.

RIC – EE – EMSB – Cultures of Equity Example PPT 6.2025Download

Making the Case for Equity

A research-backed guide outlining the tangible organizational benefits of investing in health equity—including regulatory compliance, quality improvement, value-based care performance, and stronger patient and provider experiences—useful for building buy-in across leadership and stakeholders.

RIC – EE – EMSB – Making the Case for Equity 6.2025Download

Self-Assessment Topics and Questions:

This self-assessment tool will help you identify, anticipate and address common challenges implementing the Roadmap.  Using it will increase your chances of successfully reducing and eliminating health and healthcare inequities. Each Roadmap component will have a set of questions and topics in their respective sections; AHE recommends utilizing the assessment questions in two ways:

  1. What process was used to identify key stakeholders? Please describe.
    • Did the process include backwards-mapping the formal and informal relationships beginning with the most front-line individuals who will be affected by, or affecting, implementation of the care transformation?
    • Did the process include backwards-mapping the formal and informal relationships beginning with the most front-line individuals who will be affected by, or affecting, implementation of the payment model?
    • When was the last time this process and findings were updated?
  1. Is the team aware of any key stakeholders who have not bought-in to the initiative?
  1. Who are the current key stakeholders within each partner organization that the team has identified?
    • Answer the following questions for each key stakeholder.  Is the stakeholder…
      • Supportive, neutral, or opposed?
      • Up-to-date on the status of the initiative?
    • Was the information leading to this understanding of buy-in and knowledge gathered by second- or third-hand knowledge, or was it communicated directly by the stakeholder?
  1. Who are the current key stakeholders outside of each partner organization?
    • Answer the following questions for each key stakeholder.  Is the stakeholder…
      • Supportive, neutral, or opposed?
      • Up-to-date on the status of the initiative?
    • Was the information leading to this understanding of buy-in and knowledge gathered by second- or third-hand knowledge or was it communicated directly by the stakeholder?
  1. What are your next steps for earning and/or maintaining the buy-in of each key stakeholder?
    • Please describe how these steps were identified/determined?
  1. Has the team identified the key stakeholders that are necessary for mid- and long-term support or sustainability of the initiative?  Note that these stakeholders can often be different individuals, teams, or working groups than stakeholders needed for the initial stages of the initiative.
    • Has the team asked these stakeholders to identify the key metrics or measures of success that would inform their decision about whether or not to continue supporting the initiative or sustaining it over the long-term?
      • Do the initiative’s goals and objectives incorporate these metrics or measures of success?
      • Does the initiative’s data collection and analysis plan incorporate these metrics and measures of success?
    • When was the last time that the team reported initiative progress and outcomes to these stakeholders?

Goal and Objective Setting:

About the Roadmap Goal and Objective Setting Tool

This tool is designed to facilitate goal setting and completion for your team. The tool will allow your team to:

1) Record goals that align with the various Roadmap components; 

2) Record objectives, time frames, and target completion dates, among other important items for each goal; and 

3) Monitor progress of goals per Roadmap component

Your team is welcome to engage with this tool as much or as little as it would like, and is helpful, in the development, implementation, and evaluation of your health equity initiative. We encourage you to use this tool to ensure clear goal setting and promote consistent communication, accountability, and progress within your team. This tool is designed to be used over time as your team progresses through the Roadmap and your initiative. This is in no way intended to be used one way by all teams. This is meant to help you progress through the Roadmap component(s) on which you are working at a given time and you may reach your goals in any order. We welcome you to consult your AHE TA lead on getting started with this tool.

Each Roadmap component is listed as a separate tab. Navigate to the desired Roadmap component via the task bar at the bottom of the spreadsheet to add, edit, or view goals. Hide certain tabs as needed to narrow your view to specific Roadmap components or the snapshot. Changing the status of a goal will automatically shift the Snapshot view for the specific Roadmap component.