Sustainability and Long-Term Viability

Aligning Forces for Quality (AF4Q) was the Robert Wood Johnson Foundation’s (RWJF) core initiative in its longstanding commitment to improving the quality of health care Americans receive. With this initiative, 16 grantees across the country worked through multi-stakeholder Alliances to lift the overall quality and value of health care, reduce racial and ethnic disparities in care, and provide models for national reform.

The ongoing impact of AF4Q and the ability to further AF4Q goals will be dependent, in some part, on how well Alliances demonstrate, produce, and articulate tangible value to stakeholders—physicians, hospitals, health plans, consumers, purchasers, and employers. Building Alliance and community capacity, knowledge, and skills to sustain the work of AF4Q has been an ongoing priority. At the conclusion of the program, each of the 16 Alliances was at a different point on the path toward sustainability.


A summary of the current landscape of funding in the public and private sectors can help leverage strategic opportunities to transform health care.

AF4Q Alliances have sought new ways to sustain the important work of improving the quality of health care by diversifying revenue, engaging partners, and launching new services and products. This inventory consolidates AF4Q resources about sustaining Alliances after May 2015. A few highlights from this inventory are below.

This brief describes the challenges to developing a sustainable business model and key components of success.

These slides illustrate the sustainability framework created for AF4Q Alliances by Community Wealth Partners.

These slides outline a workshop on attracting, retaining, and developing talented employees.