This year's winning U.S. Strategy Challenge team offered tough but critical advice for a Brooklyn-based non-profit seeking to offer its clients primary medical care.
In the heart of Brooklyn’s Bedford-Stuyvesant neighborhood, where stress is high and income low, The Family Center, a charity that supports families impacted by crisis, illness or loss, stands as a pillar of the community. As one client-turned-employee puts it, “Everyone is family here.”
The non-profit offers an array of much-needed social and legal services, including wellness and mental health treatment, to the 4,000 families it serves. But when an advisory committee made up of clients asked if primary medical care could be added to that list, co-founder and Executive Director Ivy Gamble Cobb saw an opportunity. “So many individuals who live in a community like ours get their care from emergency rooms,” she says. “And we saw that we might be able to offer integrated services for our families instead."
For help exploring that possibility, she and Director Jan Hudis turned for advice to Morgan Stanley, whose 10-week Strategy Challenge pro bono program matches non-profit organizations with rising talent within the firm to help solve key strategic issues. The four-member team assigned to lend their expertise to The Family Center included Maya Venkatraman, an Associate in Global Capital Markets, who found Gamble Cobb’s enthusiasm for the project infectious. “Ivy and her team are so passionate about their cause. It gave us hope to know there are people like her out there trying to make their community better,” she says, adding that her three teammates, Teresa Brady a Vice President in Legal and Compliance, Lili Driggs an Associate in the Fixed Income Division, and Shamir Parmar, a Vice President in Internal Audit, were just as eager to dive in.
Evaluating the Need
Due to numerous factors—including high costs, the inherent complexity of the healthcare system and the lack of available Medicaid providers—access to primary medical care is sorely lacking in the low-income community served by The Family Center. Might they either offer primary care themselves to serve this need or, alternately, find another organization with which to partner, its leadership asked Morgan Stanley.
To determine the answer, the team, guided by their advisor, Morgan Stanley’s Arya Sekhar, a Managing Director in Risk Management, and their coach, Peter Lavorini of the Bridgespan Group, interviewed individuals at more than twenty groups, including peer organizations and potential partners, as well as a number of additional experts and consultants, who worked at places ranging from large medical centers like New York Presbyterian to integrated care organizations like Apicha Community Health. The team also visited The Family Center's Bedford Stuyvesant offices, witnessing staff members' interactions with clients.
“We got a first-hand perspective on what they deal with daily, so that this was more than just about numbers and presentations. It was about people, about helping a community," explains Venkatraman.
When the Answer is No...For Now
At the end of the 10-week process, the Morgan Stanley team came to a consensus about the two strategic choices under consideration by The Family Center–but it wasn’t the one that either they or The Family Center’s leadership had hoped for. Nor was it one they were happy to present to panelists evaluating their results and those of eight other teams at the Strategy Challenge Final Event, at which a winner would be announced. But after evaluating the data, the team members reluctantly agreed that neither option was advisable. The Family Center, they concluded, did not have the resources to offer primary care, either on its own or by partnering with another organization.
To execute such a vision, The Family Center would have to overcome high overhead costs, low Medicaid reimbursement rates, complex regulatory issues and inadequate third party funding—challenges that simply proved too big for the organization to overcome without exposing itself to significant risk.
“The instinct is to say 'yes' and find a way to do it," Venkatraman says. “But we realized saying 'no' would actually save them from going down a path that was not financially sustainable." And it was just this frank assessment that impressed the judges, who, in a surprising decision, declared theirs the winning team.
The Silver Lining: A Framework for the Future
"While the conclusion the Morgan Stanley team reached was disappointing, the organization still feels they came out ahead. That's because the team developed two tools that The Family Center can use going forward. The first enables the organization to conduct a feasibility analysis if they want to consider offering primary care in the future. The second enables the organization to evaluate third party partnerships—either for primary care or other needs. The team also identified a peer network that could be leveraged for expertise and mentorship.
“Organizations pay consultants tens of thousands of dollars for what we got from this ten-week engagement," says Gamble Cobb. “We received two tools I think of as my Bible now. We'll be utilizing them for years to come."
And The Family Center's leadership hasn’t ruled out the possibility of offering primary care services in the future. “There's so much [regulatory[SH(S1] ] change going on in New York State as it relates to this issue. We'll see how things shake out," says Gamble Cobb.
In the meantime, Gamble Cobb is grateful to the Strategy Challenge team for keeping The Family Center from taking on a project it couldn't handle. “Morgan Stanley saved us from going down a path that could have led to the demise of the organization," says Gamble Cobb. “The best decision we ever made was to participate in the Challenge."
As for the team members who worked with Cobb, winning the Strategy Challenge was thrilling and certainly unexpected, given the fact they couldn’t find a way to realize their client’s vision. Nevertheless, their triumph was simply “the icing on the cake," says Venkatraman. “Our team was really focused on the impact we could have on the organization and the families they serve. It’s great that we were able to use the skills we learn in our jobs to help people who are bringing about change to their community.”