The community is the infrastructure: reflections from the RISE Healthy Communities Summit

By: Sujata Bajaj, Chief Technology Officer, Yuvo Health

This year's RISE Healthy Communities Summit had a different feel than in past years. Not heavy, exactly, but honest. The rebranding from "Summit on SDoH" told you something right away: The field is adapting how it talks about the work so the work itself can continue. Like a good chef reworking their menu when the seasons turn. Same ingredients, same nourishment, more attuned to the current environment.  

The numbers show what we’re up against. According to the National Association of Community Health Centers (NACHC), community health centers (CHCs) now serve nearly 34 million patients, more than 1 million more than the year before, while operating at an average margin of -2%. They're reaching more people and running deeper in the red to do it, just as more care will go uncompensated due to HR.1. 

Given that backdrop, the health plan and ACO leaders, health center teams, CBO executives, public health practitioners and community health advocates at the summit—RISE’s annual convening of cross-sector leaders working at the intersection of healthcare and social needs—weren’t pretending the last year had been easy. Shrinking public dollars and challenges to equity-focused work have put the safety net under real pressure. Still, the mood was pragmatic and resilient. 

That pragmatism showed up in a panel I moderated based on the Harvard Health Law Lab paper “Social Risk Information is Sensitive Information.” We dug into the limits of HIPAA when it comes to SDoH data and the real-world risks that it creates, from custody disputes to immigration exposure. The discussion wasn’t about pulling back from social risk screening, but about doing it intentionally and responsibly: rethinking opt-in versus opt-out approaches, defining what good data stewardship looks like across clinics, payers and CBOs, and recognizing that community-based organizations are data stewards in their own right — not just referral endpoints.

It was the energy of people who have been there for their communities through it all and are determined to keep doing it — no matter what. 

The community is the infrastructure

Rick Whitted, CEO of US Hunger highlighted an idea that struck a chord with me:

The community isn't something you build infrastructure around. The community is the infrastructure.

That reframe matters more than it might sound. 

So much of how we talk about "community partnerships" positions health centers and CBOs as delivery points. But that's not what these organizations are. They are the care infrastructure for the populations they serve. 

They exist because of their communities, are staffed by their communities and are trusted in ways that no outside system can manufacture. According to NACHC, health centers serve 1 in 3 people living in poverty, 1 in 4 racial and ethnic minorities, and 1 in 5 uninsured Americans. These are people for whom a health center is often not just the best option, but the only one.

Mr. Whitted’s comments weren’t unique. A powerful throughline ran across nearly every session I attended:

If we want better outcomes, we have to design systems that reflect real lives — not the patient we wish was sitting in front of us.

Donna Cryer drew an insightful distinction between being a community to the people you serve versus a community with them. It's a subtle difference, but it changes everything about how you design programs, what data you collect and whose priorities you're actually centering.

At Yuvo Health, we think about health centers the same way we think about community: not as delivery points, but as the actual infrastructure of care. The work we do helping health centers succeed in value-based care, reducing the administrative burden and creating sustainable revenue is only meaningful if it strengthens what health centers are already doing for their communities. We're here to support that, not to redirect it.

The field is navigating real headwinds right now. But the people doing this work aren't waiting for conditions to improve. They're building within the constraints, protecting the mission and showing up for the communities that depend on them. That's what I took home from Orlando, and what I see among our CHC partners and Yuvo team every day. 

‍