The Fund supports networks of state health policy decision makers to help identify, inspire, and inform policy leaders.
A bipartisan group of state health policymakers from both the executive and legislative branches who are focused on improving population health.
Networks of state officials, advocates, and others aiming to invest in and transform primary care.
A program dedicated to advancing state-based efforts to make health care more affordable for residents, employers, and states.
The Milbank Memorial Fund supports two state leadership programs for legislative and executive branch state government officials committed to improving population health.
A leadership development program for early and mid-career state government officials who are committed to improving the health of all people in their communities.
A leadership program for senior state government officials who are committed to improving population health.
The Fund focuses on creating an affordable health care system built on strong primary care and partnerships that improve health outcomes for all.
Improving state leaders’ ability to enact and implement evidence-based health policies.
Advancing policies that create a more prevention- and primary care-oriented health system.
Improving population health through policies that contain health care cost growth.
Our state health policy resources offer relevant data analysis and best practices.
The Fund publishes reports, issues briefs, and case studies on state health policy issues.
Short takes on health policy issues from Milbank staff and guest authors.
Insights from Milbank President Debra Lubar on state health policymaking.
Reported articles and Q&As on timely health policy issues, as well as foundation updates.
Milbank Memorial Fund and Milbank Quarterly webinars featuring state health policymakers and researchers.
Updates and expert contact information for reporters.
The Milbank Memorial Fund is a private foundation that works to improve population health and health equity.
May 9, 2025
Policy Report
Casey Balio
Nicole Galler
Nathan Dockery
Michael Meit
Publication
Jul 23, 2026
Jul 15, 2026
Jul 14, 2026
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. 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 report 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.
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