The Community Hypertension Prevention Initiative (CHPI) is pay-for-success partnership between the Heart & Stroke Foundation (H&SF), the Public Health Agency of Canada (PHAC) and the MaRS Centre for Impact Investing (MCII). It is the first Federal Government sponsored pay-for-success contract (also known as a Social Impact Bond) in Canada and the first one focused on health.
A Social Impact Bond (SIB) is essentially a pay-for-success contact in which the government agrees to pay for improved social outcomes. A partnership between investors, service delivery organizations and government is established to tackle a specific social issue. If the solution achieves the agreed-upon social outcomes, the government pays the investors against a pre-agreed scale. As such, the risk of non-performance is transferred away from the government to the investors, whose financial return is based on the achievement of outcomes.
The Community Hypertensions Prevention Initiative works with pharmacies, H&SF community partners and a digital technology platform to increase awareness of high blood pressure and cardiovascular disease risk, while supporting healthier lifestyles to reduce the onset and prevalence of hypertension.Left untreated, half of Canadians over 60 with blood pressure in the high-normal range will develop hypertension within four years. If the three-year prevention initiative succeeds in stopping that trajectory, PHAC will pay the MaRS investors a market rate return.
Innovation and Philosophy
As the first Federal government sponsored SIB in Canada, the CHPI is an important event in the maturation of the Canada social finance sector. The pay-for-success model allows highly effective non-profit organizations attract private investment. As government and philanthropic resources become increasingly stretched, this access to private capital will become essential to addressing and funding solutions to the most pressing social and environmental issues of our time.
Additionally, the participation by the Federal Government in CHPI signals a willingness and interest in exploring alternative financing instruments to accelerate social change. The models’ rigorous focus on outcomes emphasizes the end result rather than how it is achieved. This encourages innovation in service delivery and a focus on creating impactful change.
Hypertension, also known as high blood pressure, is one of Canada’s most serious health-care issues. If left uncontrolled, hypertension can lead to stroke, heart disease, and other serious conditions. 66,000 Canadians die each year as a result of heart disease and stroke yet research shows that up to 80% of premature heart disease and stroke can be prevented by adopting healthy behaviours.
This initiative is targeting 7,000 adults over age 60 for the healthy behaviour support and will screen up to 29,000 people who will also receive hypertension prevention information.