The Hub and Spoke Healthcare Unit

Our model is designed to work fully for the poor in one the world’s most impossible places. It creates impact beyond a single site or intervention.

It’s a hub and spoke healthcare unit built within the government’s existing infrastructure. Our team delivers healthcare at a hospital, network of clinics, and via community health workers.

This model design allows us to deliver integrated healthcare aligned with national priorities.

The goals of this model are to spend under $20 per person and improve six key health outcomes for an entire population.

“It is a model with all the right pieces— it reaches the poorest, government resources are leveraged, and data and transparency are used to prove that results demand more investment.”

+  Governor Howard Dean, M.D.


Durable Healthcare

Traditional models of healthcare operating on their own fail to solve the problems of the world’s poorest patients.

The poorest can’t access the private sector due to cost. The public sector fails to deliver on quality. And philanthropy can produce pockets of excellence, but can’t achieve the scale needed.

As a result, there is a huge market of people who are not served by these three standard approaches. But there is a fourth way — what we call durable healthcare.

Durable healthcare is a healthcare system design that solves for the poorest patients. It’s a public-private partnership that enables a nonprofit healthcare company to be paid by the government to deliver healthcare within the government’s infrastructure.

It brings together the quality of the private sector, access of the public sector, and innovation enabled by philanthropy. And it ties core financing to performance.

Learn more about Durable Healthcare in our latest TEDx talk.

“This design brings together the best assets of each sector: the government finances and provides infrastructure, we bring management acumen and only get paid if we deliver outcomes. Most importantly, because we are a nonprofit healthcare company, we only need to achieve cost recovery, not profitability. That changes everything. It allows us to go where no private company would see opportunity and use the combination of government funding and philanthropy to build a system that works fully for the poor.”

+ Mark Arnoldy, CEO



Durable Healthcare

Designed For Scale

Why Nepal?