The Fund supports networks of state health policy decision makers to help identify, inspire, and inform policy leaders.
The Milbank Memorial Fund supports two state leadership programs for legislative and executive branch state government officials committed to improving population health.
The Fund identifies and shares policy ideas and analysis to advance state health leadership, strong primary care, and sustainable health care costs.
Keep up with news and updates from the Milbank Memorial Fund. And read the latest blogs from our thought leaders, including Fund President Christopher F. Koller.
The Fund publishes The Milbank Quarterly, as well as reports, issues briefs, and case studies on topics important to health policy leaders.
The Milbank Memorial Fund is is a foundation that works to improve population health and health equity.
May 9, 2025
Report
Casey Balio
Nicole Galler
Nathan Dockery
Michael Meit
Publication
Apr 18, 2025
Mar 12, 2025
Nov 25, 2024
Back to Publications
The United States ranks below peer nations on many measures of health status, health care access and quality, and health outcomes while spending significantly more on health care.1 This combination of factors has driven an effort to better align resources with need to address health disparities and use funds more efficiently. To identify areas with high need, area-level vulnerability and resilience indices (ALVRIs) have been developed to create composite need scores based on combined underlying measures. Federal, state, and local agencies, as well as philanthropies, are using ALVRIs as data-driven strategies to better allocate resources and improve outcomes. This brief describes the historical approaches to resource allocation, introduces ALVRIs, and provides considerations for decision makers in states that are using an ALVRI, such as state health officials, Medicaid directors, hospital and health system administrators, and other state agency and department directors.
Blumenthal D, Gumas ED, Shah A, Gunja MZ, Williams RD II. Mirror, Mirror 2024: A Portrait of the Failing U.S. Health System. 2024. Accessed December 10, 2024. https://www. commonwealthfund.org/publications/fund-reports/2024/sep/mirror-mirror-2024