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Rural Health Information Hub

Develop a Business Case for Your Community Health Program

It is important to plan for sustainability from the beginning of designing a program. Rural communities should consider how they will continue to sustain a program after initial grant funding has ended. For example, rural communities should consider what kind of data they need to collect to demonstrate the benefits of their program and make a business case for continued investment.

A business case is particularly important in rural areas for justifying costs and use of limited resources. This information may help leadership and management, sponsors and funders, and other stakeholders understand the importance of the program or investment.

Business Case Components

A business case is a concise document. The required elements may differ depending on the sponsor or funder. At a minimum, an effective business case describes the problem; identifies a solution; provides a rationale for the solution; outlines risks, costs, and benefits; and provides a timeline for return on investment.

Key components of a written business case include:

  • Executive Summary – Provides a concise overview of the topics addressed in the business case.
  • Background – Introduces the problem or need for the program and highlights service gaps in the community. Uses needs assessment data to connect the problem to the local community.
  • Solution or Project Description – Describes the preferred solution and explains how the solution will be implemented. Presents evidence of effectiveness, such as success stories and lessons from other programs. Describes the benefits of the program as well as its limitations and risks. Identifies the project approach, including existing resources and capacity to support implementation, and discusses potential for success. Presents the timeline for implementation.
  • Costs – Estimates the total costs, including direct costs (for example, staff and equipment) and indirect costs (for example, staff turnover and loss of productivity). Assesses program affordability and value.
  • Sustainability – Explores long-term strategies for sustainability, such as financing and reimbursement. Addresses return on investment. For more information, see Module 4: Evaluating Rural Programs and Module 5: Planning for Funding and Sustainability.

Implementation Considerations

It is important to tailor a business case to its specific audience. If the business case is intended for organizational leadership, for example, data can support organizational improvements, benefits, and return on investment. If the business case is for an external funder or sponsor, data can focus on community needs, benefits, and sustainability.

Resources to Learn More

Business Case for Population Health: Total Cost of Ownership and Return on Investment
Provides an Excel tool to help rural communities calculate the return on investment (ROI) from implementing alternative or risk-based payment programs.
Organization(s): RUPRI Center for Rural Health Policy Analysis, Stratis Health

Business Case Template
Provides a template of a business case that rural communities can tailor to describe their program and intended outcomes.
Organization(s): Centers for Disease Control and Prevention

Business Case Toolkit
Provides a step-by-step guide to creating a business case. Covers formatting and structure, dealing with finance, building evidence, and monitoring and evaluation.
Organization: British Heart Foundation

Capturing Value in Social Health: Lessons in Developing the Business Case for Social Health Integration in Primary Care
An analysis of a business case developed by 12 primary care teams to support the increase and sustainability of social health interventions in institutional and market settings.
Organization(s): The Commonwealth Fund

Case Study Business Plan: Rural Health Network Development
Provides an example of a business case for a rural health network.
Organization(s): Rural Health Innovations, National Rural Health Resource Center
Date: 8/2015

The Dynamics of Sustainability: A Primer for Rural Health Organizations
Offers information for organizations and their partners on preparing and planning for stability and sustainability at the beginning of a new program.
Organization(s): Georgia Health Policy Center
Date: 2/2012