Earn and Sustain Stakeholder Buy-In
What does it mean to earn and sustain stakeholder buy-in, and why is it important?
Earning and sustaining buy-in is not simply gaining passive agreement or approval for your initiative. It means designing and implementing a strategy to earn a commitment from everyone that you need for your initiative to succeed: to take specific actions or provide specific resources. Without this type of buy-in, initiatives risk resistance, resource gaps, and failure to integrate into existing systems.
When should I earn and sustain stakeholder buy-in?
Earning and sustaining stakeholder buy-in is an ongoing activity throughout the life of every health equity initiative. Take action to actively earn buy-in when implementing each component of the Roadmap and consistently sustain it over time. If your team encounters resistance or disengagement, use the resources below to revisit your buy-in strategies—especially with leadership and frontline staff—to realign and move forward effectively.
The chart below details the steps as well as the approximate number of meetings for which to plan, while recognizing that the estimates will vary from team to team.
| Key Activities | Time Estimate: ~ 20+ Hours |
|---|---|
| Engage in learning around the status quo | Variable estimates based on pre-existing knowledge |
| Identify and partner with stakeholders | Variable based on partner organization size and complexity |
| Engage in a culture of equity training and experiences | Revisit throughout the course of initiatives to advance health equity |
| Create key messages for all stakeholder groups | 2-3 one-hour meetings |
| Evaluate efforts and incorporate feedback | Revisit throughout the course of initiatives to advance health equity |
How should I earn and sustain stakeholder buy-in?
Begin by viewing the Earning and Sustaining Stakeholder Buy-In presentation, 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. After you complete the initial presentation, work through the remaining resources listed below.
Resources for Earning and Sustaining Stakeholder Buy-In
Earning and Sustaining Stakeholder Buy-In
Strategies for building and maintaining stakeholder commitment—including crafting targeted messages, anticipating concerns, and tailoring engagement for staff, leadership, providers, and community partners.
Spreading Your Message: A Tool for Teams
A structured worksheet that helps teams craft targeted key messages for each stakeholder audience—anticipating their concerns and selecting the right delivery mode. It includes a guided table for message development and prompts for drafting communications across formats such as email, presentations, and outreach letters.
Stakeholder Identification and Action Planning 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.
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.
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.
Designing and Implementing Integrated Care and Payment Transformation Initiatives to Advance Health Equity: Lessons Learned from Three Pioneering Health Care Provider and Health Plan Partnerships
Sometimes it is helpful to learn from others’ experiences. This report presents case studies of care and payment transformation models designed and implemented by three pairs of health care provider and health plan partnerships to advance health equity. See page 30 for important lessons they learned about partnering with patients and community members.
Assessing and Improving Stakeholder Buy-In
| Assesment Questions | Next Steps |
|---|---|
| Teams and individuals with the least power in an organization’s hierarchy are less likely to have had anyone consider or assess their buy-in — even if the success of a care transformation or payment model depends on their support and behavior change. What steps have you taken to directly verify that their buy-in has been assessed and earned? Is your initiative suffering from vague or poorly defined implementation challenges? Have any key stakeholders provided verbal buy-in, but have not engaged in specific actions or offered tangible resources to support implementation? Is the team aware of any key stakeholders who have not bought into the initiative? Is the current stakeholder list for your initiative complete? Don’t forget to consider key stakeholders outside of your organization. What are your next steps for earning and/or sustaining the buy-in of each key stakeholder? | Review the Stakeholder and Action Planning Tool and ask yourself the following questions: * Did the process include backwards-mapping formal and informal relationships, beginning with the front-line individuals who will be most affected, or affecting the implementation of the care transformation? * Did the process include backwards-mapping formal and informal relationships beginning with the front-line individuals who will be most affected, or affecting the implementation of the payment model? * When was the last time the process and findings were updated? |
| Are you keeping all stakeholders up-to-date on the status of the initiative, including successes and challenges? | If not, create and implement a plan to provide consistent communications updates to key stakeholders. Remember to celebrate wins and ask for support as needed. |
| Was the information leading to the knowledge of the initiative held by each stakeholder and their level of buy-in communicated to your or your team via the use of second- or third-hand knowledge? Or was it communicated to you or a member of your team by each stakeholder? | Make a plan to communicate directly with all key stakeholders for whom you only have second- or third-hand knowledge regarding their understanding of the initiative or their specific commitment to support the initiative by specific action(s) or resource provision. |
Has the team identified the key stakeholders that are necessary for mid- and long-term support, sustainability, or spread 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. | Utilize the Stakeholder and Action Planning Tool to identify any new key stakeholders needed for long-term support, sustainability, or spread of the initiative. * Ask these stakeholders to identify the key metrics or measures of success that would inform their decision about whether to continue supporting, sustaining, or spreading the initiative over the long-term? – Ensure that the initiative’s goals and objectives incorporate those metrics or measures of success. – Ensure that the initiative’s data collection and analysis plans incorporate those metrics and measures of success. * When was the last time that the team reported initiative progress and outcomes to those stakeholders? Be sure to include these stakeholders in ongoing updates regarding the initiative’s successes and challenges. |
About the Roadmap Goal and Objective Setting Tool
Use the Roadmap Goal and Objective Setting tool to facilitate and document the development, implementation, and evaluation phases of your health equity initiative. It will help your team realize your vision to reduce and eliminate health and healthcare inequities by providing a centralized resource to:
- establish process goals that align with each Roadmap component;
- document task status, identify project champions, and maintain detailed notes;
- monitor progress across multiple Roadmap components simultaneously; and
- promote consistent team communication, accountability, and progress.