Traditionally, responses to crises and societal problems—the Covid-19 pandemic, natural disasters, racial inequities—are considered the responsibility of the public sector and NGOs. But addressing the world’s most critical problems requires leadership, resources, and skills beyond those of any single organization, industry, sector, or government. What’s needed, the authors argue, is high-impact coalitions—an emerging organizational form that reaches across boundaries of business, governments, and NGOs.
Although public-private partnerships have existed for some time in various forms, large cross-sector, multistakeholder initiatives are newly resurgent and not yet widely understood. They are more voluntary and relationship-based than formal organizations but more task-directed than networks. They connect otherwise disparate spheres of activity that bear on big problems by aligning powerful actors behind a purpose-driven mission. Once underway, they can harness and utilize capabilities quickly and flexibly.
If you ask CEOs what keeps them up at night, you find that their worries go well beyond staying ahead of the competition. Increasingly they worry about big systemic challenges and what they can do to help fix them. That’s because they’re keenly aware of people’s expectations: A high proportion of stakeholders—86% on the 2021 Edelman Trust Barometer—believe that business executives must play a lead role in tackling societal issues.
Traditionally, spearheading the responses to crises and catastrophes—the Covid-19 pandemic; climate disasters such as hurricanes, floods, and heat waves; racial disparities—is considered the responsibility of the public sector and NGOs. Of course, businesses and their resources and expertise can be tapped to provide aid: Commercial airlines, for example, assisted the U.S. government with evacuation flights out of Kabul in 2021; shipping companies such as FedEx and UPS were asked by the White House to operate 24/7 to ease pandemic-related supply-chain bottlenecks; and large retailers such as Walmart have helped federal emergency agencies by distributing bottled water and other goods following extreme weather events.
Yet responding to specific calls is no longer enough; today’s business leaders must be more than followers. We argue that they can best respond to big societal challenges through what we call high-impact coalitions—an emerging organizational form that reaches across boundaries of business, governments, and NGOs. In this article, we draw on the experience of many such coalitions, including several that are responding in significant ways to the pandemic, to lay out the features and principles that make the difference between success and failure. Leading and participating in these coalitions may well require actions that go against the grain for executives used to the calculus of business competition, but it can also supercharge a company’s sense of purpose and produce a treasure trove of ideas and partnerships.
An Emerging Organizational Form
Although public-private partnerships have existed for some time in various forms, large cross-sector, multistakeholder initiatives are newly resurgent and are not yet widely understood. They are more voluntary and relationship-based than formal organizations but more task-directed than networks. They connect otherwise disparate spheres of activity that bear on big problems by aligning powerful actors behind a purpose-driven mission. They are particularly well-suited for addressing systemic challenges. Once underway, they can harness and utilize capabilities quickly and flexibly. High-impact coalitions are characterized by:
Open boundaries. Barriers to membership are low. Members give time, resources, and expertise according to their means and interests. Leaders of member organizations tap their personal relationships to recruit others. As new participants join, the reach of the coalition broadens and receptivity to its goals extends beyond its membership. Of course, low barriers to entry also mean low barriers to exit, but that can be an advantage: Members at the periphery simply fade away if they disagree, rather than making a fuss, lowering the conflict level.
The Covid-19 Healthcare Coalition (C19HCC), which began in March 2020, is a case in point. A small group of dedicated leaders from 18 diverse organizations, including Amazon Web Services, Epic, Mayo Clinic, and Microsoft, came together quickly to mount a private-sector pandemic response contributing to national and state government efforts. They in turn brought in contacts of their own to create a coalition of more than 1,000 organizations in 16 working groups.
Barriers to membership in coalitions are low. Members give time, resources, and expertise according to their means and interests.
Another example is West Side United (WSU), a coalition of six large hospital systems along with numerous community organizations and financial institutions, formed in 2017. Its ambitious goal is to end racial disparities in life expectancy on Chicago’s West Side, which stem from inequities in health and economic systems. As more organizations joined, members found ever-expanding ways to carry out the mission. Hospitals, for example, changed internal practices and purchasing protocols and opened new job pathways. When the pandemic struck, Chicago mayor Lori Lightfoot asked WSU to further widen its scope and membership, this time in behalf of the whole city, by heading up a multipronged Racial Equity Rapid Response (RERR) effort. Within a few months, the RERR had distributed more than 60,000 surgical masks, 200,000 units of hand sanitizer, and 750,000 cloth masks to the community. It also supported food centers in deprived areas and provided resources to keep local businesses afloat.
Emergent structures for evolving tasks. Coalitions often confront challenges for which no proven path yet exists, so it can be easy to become mired in time-wasting debates about how to get organized. Successful coalitions attempt to minimize rules and requirements and just dive in. Members remain independent, continuing to carry out their own work, and step in to collaborate or direct tasks when their capabilities matter. At different times, different groups of members bear the brunt of the workload.
For C19HCC, the initial group of companies grew through word of mouth and expressions of online interest. Members self-organized into working groups focused on specific areas such as analytics, supply chains, telehealth, and the detection of misinformation. Capability needs shifted over time as some problems were addressed and others surfaced. In weekly virtual working meetings, members focused on tasks and nurturing new relationships. In monthly strategy meetings, they shared information and updates without overburdening one another with detail. A dedicated staff served as the coalition backbone, coordinating schedules and tasks.
In the first months of the pandemic, the priority challenge was getting personal protective equipment (PPE) to New York. The coalition formed a supply-chain working group that identified and encouraged global manufacturers to convert production lines to medical supplies. It researched, assembled, and published decontamination tactics to enable reuse of PPE. It also created a system for cataloging PPE for distribution. C19HCC delivered through the governor’s office 575,000 KN95 respirators to New York City hospitals in the spring of 2020—an early, motivating win. Later, as information gained importance, another group of members developed data collection and analytics applications and tools to support decision-makers. This work contributed to the development of a rich, publicly available library of hundreds of data sets, models, and dashboards.
Coalitions require coordination to make sure that members do not work at cross-purposes or duplicate efforts. Sometimes, founders will invite or create a dedicated team to perform this backbone role. For example, MITRE, a not-for-profit, federally funded research and development organization, served as C19HCC’s facilitator. In Chicago, WSU operated for a few years with coordination help from Rush University Medical Center, one of the founding hospitals, before it hired an executive director. With a credible organization taking on the role of backbone, members can more easily negotiate common ground.
A mission-determined life span. High-impact coalitions are intended to solve problems that can’t be handled without collaboration or alignment of multiple entities. If the crisis at hand is immediate yet temporary—as is the case with aspects of the Covid-19 pandemic—they will have a short life span, dissolving as the need evaporates.
Chronic, multifaceted, structurally rooted challenges call for deeper systemic change. As some problems are addressed, new ones arise—that’s why successful coalitions may evolve into platforms that coordinate multiple projects and a succession of issues. One round of work is followed by another as activities gradually become aligned behind a new way of doing things.
WSU is an example of a coalition that is evolving, but very carefully. Its mission to close the racial life-expectancy gap can be achieved only through a sustained, long-term effort to align on many fronts: employment, education, housing, health care, and economic investment. Although WSU brought on an executive director after a few years, it has stayed lean with high member engagement. As it took on more tasks during the pandemic, a big question for its leaders was whether to reduce dependence on its first home, at Rush University Medical Center, and become its own entity. The decision was to set up formal legal structures while still emphasizing strong leadership from its members.
Overall, high-impact coalitions keep structures and rules loose, but relationships tight. Members maintain a great deal of independence and have discretion about participation, but strong relationships serve as a control mechanism to gently steer efforts to a productive end. Coalitions seek breadth and maximize diversity. Member organizations and their leaders step in but also step aside as needs change. Our experience examining high-impact coalitions responding to the pandemic suggests that success is rooted in five key organizational principles.
1. Exercise Moral Leadership
Successful coalitions form out of a sense of higher purpose and dedication to a cause greater than the interests of member organizations alone. In most cases they are put together by respected veterans in the field with long-standing dedication to the issues. Coalition leaders have a sense of responsibility tempered by humility: They understand the magnitude of the problem and are well positioned to help, but they must count on the involvement of many other organizations to make progress.
Trigger events—a sudden crisis, newly discovered evidence, something changing in the external environment—propel leaders into discussions with a few close colleagues, including peers in high-level positions in other organizations. For example, John Halamka, of Mayo Clinic Platform, and Brian Anderson and Jay Schnitzer, of MITRE, all well-connected health care IT executives, made a few calls around the country and persuaded others to come on board at C19HCC.
A significant, inspiring mission is part of what attracts followers, and the goal of a high-impact coalition should transcend outcomes that independent organizational efforts could produce on their own. In recruiting peers from other hospitals, the initiators of WSU had to make it clear that they were not acting for the benefit of Rush but were focused on addressing inequities for the entire West Side region (some half a million residents) and perhaps millions of others—a mission much bigger than anything their own organization could accomplish alone.
But mission must be supported by something tangible. Under its grand purpose of saving lives, C19HCC developed three measurable goals: achieving real-time learning from patient data; supporting an affordable and scalable supply chain for critical medical supplies; and raising awareness and advocating for nonpharmaceutical interventions such as social distancing, mask wearing, and handwashing. WSU not only identified a basic strategy for achieving its mission but also drilled down to specific actions that would mark tangible progress toward achieving racial equity in life expectancy and health. Working groups coalesced on such issues as hospital hiring, maternal health, and the funding of neighborhood businesses.
Belief in the cause must be supported by belief in the power of joint action to achieve specific outcomes. That’s what makes quick wins so important. Tangible goals are more achievable and visible than behavior-change goals, so they are a great place to start. For example, civic coalitions can more readily renovate downtowns than fix their schools, and pandemic action coalitions can more easily make and distribute PPE than overcome vaccine hesitancy.
2. Operate at the Speed of Trust
The speed and effectiveness of action depends on how quickly trust can be developed. Governance and operations for high-impact coalitions are built on trust among members rather than on formal contracts or financial incentives—which explains why some coalitions take time to get moving, while others spring into action immediately.
C19HCC got off to a quick start because it drew on many previously established relationships. The first members could get right into agenda setting and form working groups purely on trust. Their explicit adoption of guiding principles—including agreeing to participate for the benefit of the country without seeking profit and to share plans openly—further forged its trust-based nature. With WSU, there was an initial burst of speed in engaging other hospital systems. Rush’s David Ansell held medical-practice and leadership roles at each of the first three hospitals forming WSU; Rush’s then-CEO, Larry Goodman, championed the initiative and convened the others. What also helped was that despite their differences—one hospital was academic, one not-for-profit, and one public—the health systems spoke the same language and employed individuals with similar educational backgrounds. And once a few were on board, others didn’t want to be left out.
CEOs commit their firms to membership, but they rely on the buy-in of their people to carry out those commitments.
Even business rivals can build trust quickly and find a shared purpose because of their similarities and prior relationships. For instance, Google and Apple jointly developed a privacy-protecting exposure-notification system for pandemic contact tracing. Similarly, when Covid-19 vaccines became available, pharmacy competitors CVS and Walgreens collaborated in a federal partnership to vaccinate staff and residents of long-term care facilities, sharing one moral mission: to vaccinate as many people as possible. As part of the CoVIg-19 Plasma Alliance, pharma company Takeda and biotech firm CSL Behring pooled efforts to develop an unbranded generic treatment for Covid-19, forgoing the pursuit of their own branded products.
Uniting organizations that have very different norms, cultures, and stakeholders is much more challenging. Troubling histories of conflict (and, in the case of Chicago, racial injustices) can make representatives with long memories suspicious and mistrustful. That’s why, despite its fast start, WSU had to slow down so that “elite” executives from big companies could listen to and acknowledge the differing views of community members and neighborhood organizations and engage them as equal partners in decision-making.
WSU members who wanted rapid change found the trust-building process excruciatingly slow: large town halls in community college auditoriums; months of listening sessions in churches, storefronts, and apartment buildings; reports featuring community voices; working groups to set priorities; and eventually the hiring of an executive director, Ayesha Jaco, a well-known leader in the community. But the longer process was warranted in light of more than 50 years of community mistrust that WSU had to overcome before it could get moving. And it was because of its work building trust across all stakeholders that Mayor Lightfoot drew on its leadership during the pandemic.
Trust is especially important when no single decision-maker is designated to resolve stalemates. Independent coalition members have to let go of their proprietary or preferred methods as they seek common ground with others. For example, C19HCC’s focus on data-driven solutions seems at first blush to be objective and uncontentious, but the coalition had to grapple with the inherent lack of data standards in U.S. health care across geographies, systems, and levels of care. Many minds had to agree on definitions and standards. And, even harder, everyone had to agree on an approach to analyzing data and sharing results.
In these situations, sharing information openly and abundantly, maintaining highly porous boundaries, assigning collective credit, and reiterating the purpose behind the tasks can go a long way.
3. Find a Balance of Commitments
Leaders of high-impact coalitions must be adept at operating in the Goldilocks zone of Just Right: not full-time, but not casual either; aligned sufficiently to achieve a shared purpose but requiring little change to member organizations’ own systems. It’s a matter of balance. A bank is still a bank, a software firm still creates software, but they must steer those capabilities in new directions that address the coalition’s purpose.
To succeed, coalition leaders must know what they can request of their members. How much can they commit? What are the resources and capabilities, information and expertise, or credibility and legitimacy that each member has to offer? As we’ve pointed out, participation will ebb and flow as needs change and new members come on board.
Members also need to identify who among their employees will be deployed in coalition work. CEOs might commit their firms to membership, but they will need to rely on the buy-in of their people to carry out those commitments. When the five hospitals joined Rush and WSU, Ansell’s prominence in the Chicago medical community and Goodman’s enthusiasm for the initiative were key factors n persuading people to get on board.
Of course, Ansell, Goodman, and other WSU leaders had their own jobs with differing goals, roles, and time commitments; they had to find ways to return home with benefits for their own health system. Community leaders had the same issue. And before a formal coordination structure was developed, WSU faced collaboration challenges stemming from differences in egos and decision-making styles. Even in coalitions that are explicit about sharing credit and don’t differentiate among members, human dynamics mean that some people want their voices to count more than others’.
Finding the right balance requires that organizations hold honest internal dialogues before they sign up. When one Chicago bank joined WSU, executives held conversations with units from online banking to small-business lending before they made commitments. After all, people from those units would be doing the actual work.
4. Navigate Competing Coalitions
Coalitions stretch even the most adept leaders’ skills at managing relationships. Societal change is daunting, and systems are big and overlapping. A dizzying array of coalitions may be operating in the same space, often vying for the same partners. Because high-impact coalitions form so easily and their boundaries are fluid, their membership is continually morphing.
C19HCC operated alongside many coalitions with overlapping membership. The Covid-19 Research Database, coordinated by the health IT company Datavant and the nonprofit Health Care Cost Institute, provided analytics and data on more than 300 million patients; a Covid-patient-recovery alliance was formed by the consulting firm of a former governor; and a YPO (Young Presidents’ Organization) manufacturing coalition tapped 433 member companies to create a domestic supply chain for essential Covid supplies. Some companies formed more-specialized collaborations: 3M worked with Ford and GE to make ventilators and respirators; the Covid Collaborative worked with the Ad Council on messaging. Local initiatives also sprang up, such as GOTVax, a Boston coalition of community organizers, local officials, public housing authorities, students, physicians, nonprofits, vaccine suppliers, and emergency medical services, which delivered vaccinations in lower-income areas through mobile pop-up clinics.
Getting involved in multiple coalition groups can pull an organization’s resources in too many directions. Rush was WSU’s first fiscal home. But it was also sought after by several other coalitions. In 2018, shortly after WSU started to come together, U.S. senator Dick Durbin launched a 10-hospital initiative, Chicago HEAL (Hospital Engagement, Action, and Leadership), to address gun violence and community conditions, with Rush’s participation. In 2020, Rush joined C19HCC. Its leaders wondered whether Rush would have enough attention left for WSU if its teams were spread across many initiatives. Fortunately, WSU’s coordinators, especially David Ansell, Darlene Hightower (then Rush’s VP of community health equity), and Ayesha Jaco, knew how to bridge coalitions. They helped foster a common language and perspective that would ensure that each effort enhanced rather than detracted from the others.
Coalitions are not bureaucratic entities with narrow goals; they are a means to reach beyond what member organizations already know.
Of course, WSU’s leaders struggled with finding the right balance. Some people on the steering committee had qualms about accepting Mayor Lightfoot’s invitation to lead RERR, believing that the challenge could distract from the coalition’s core mission. After all, they were still in the early stages of their journey; leaders worried about taking on more work and broadening their scope before they had robust groups with proven leaders. Ultimately, they decided that RERR was on mission, had utmost urgency, and would also serve their West Side constituencies. More than a year later, when Mayor Lightfoot started public health councils for racial equity throughout the city, the WSU coalition was used as a model of business–community collaboration and became the council for its own 10-neighborhood area.
Making change in large-scale systems can be contentious, and one coalition might actively undermine another, often by mobilizing people or organizations that have been left out of the process. Although C19HCC and WSU avoided this trap, other, more-politicized coalitions are less inclusive. Boston’s experience of considering a bid on the 2024 Olympics is instructive. A cross-sector coalition initiated by a business leader and his counterparts championed a bid because, they said, it could bring economic and infrastructure benefits to all parts of the community. But the business-led coalition became identified more with the agendas of its leaders than with its mission of civic betterment; it failed to include enough stakeholders outside of a tight elite circle. That made it easy for a small, barely funded coalition to arise in opposition, rally those who felt left out, and ultimately prevail. Neglect inclusiveness at your peril.
5. Focus on Solutions
Purpose-driven, mission-driven coalitions to improve societal outcomes—such as saving lives in the pandemic, achieving health equity, or addressing climate change—are designed to produce public goods solutions, not to generate competitive advantages for their members.
Effective coalitions are not bureaucratic entities with narrow goals; rather, they are a means to reach beyond what a company already knows. They succeed best when members are open to learning from one another in order to guide joint actions—and along the way they may even change their own thinking. Collaborations combine ideas from partner companies to tap creativity, find innovations, and fill gaps, as WSU did with its new workforce development models and as C19HCC did with its large-scale telehealth impact studies.
Leaders with imagination will see ways that their organizations can capture some future value from what has been learned. For instance, CVS’s activities during the pandemic have been monitored closely by a top executive team, and some of the initiatives prompted the leaders to think about their business differently and develop new ventures, such as reopening a readiness service for corporate customers (Delta Airlines was among the first) and a clinical-trial recruitment service for pharmaceutical collaborators. C19HCC member Microsoft launched a mission-driven societal-resilience initiative deploying innovative technological tools to address inequitable access to Covid-19 vaccines—an innovation of global value during and after the pandemic.
Leaders who remain personally involved in the ideas flowing from high-impact coalitions open their minds to new possibilities, especially when the coalition reaches well beyond the usual suspects of industry peers and into the community. They learn from others’ expertise, they enlarge their networks and engage with influential people from other sectors, and they benefit from the prestige associated with coalition participation—the reflected glory or halo effect of being part of a noble effort. They may even identify new products and markets along the way. Ultimately, solving big problems can be a mission, a passion, a cause—and an opportunity.
High-impact coalitions are an underrecognized organizational form addressing systemic challenges that require leadership, resources, and skills beyond those of any single organization, industry, or sector. They succeed when members view the collective goal as a moral imperative; when they build relationships quickly and balance competing claims on their employees; when they can choose how they want to contribute without having to endorse what others are doing; and when they communicate regularly so as not to work at cross-purposes. They use imagination to examine coalitions’ missions to recognize potential business innovations embedded in them. Put simply, participating in high-impact coalitions is a chance for companies to build next-level leadership skills while ensuring that business—along with society—actually has a future.
Copyright 2022 Harvard Business School Publishing Corp. Distributed by The New York Times Syndicate.