General Questions

Investing in the HCX

Program Questions

HCX Process

General Questions

What is the Health Credit Exchange (HCX)?

The HCX is a neutral platform that connects companies to vetted and innovative health and wellness programs. Private contributions are pooled in a fund and paid to providers based on performance. Through the HCX, local and global companies can co-invest to drive and scale better health outcomes while receiving clear and verified results. These attributable results fuel a company’s ability to improve accountability and increase their social investments.

What role does GBCHealth play in the Health Credit Exchange (HCX)?

GBCHealth works with international development stakeholders to improve collaboration in the design and implementation of health and wellness programs. The HCX is a partnership platform that gives donors, companies and NGOs an opportunity to better align priorities and co-invest for impact. GBCHealth owns and manages the HCX. In this pursuit, the organization identifies programs to post on the Exchange, solicits concept notes, conducts due diligence, monitors program progress and verifies results are achieved (with the help of a third party) before authorizing incentive payments.

In addition, GBCHealth counsels companies on their social impact programs and mobilizes coalitions to support smart investments in global health.

Finally, GBCHealth works with program implementers to furnish progress and impact reports to corporate investors to demonstrate a program’s annual social returns.

How does the HCX enable the private sector to work with large institutional or government donors?

The HCX provides a window for the private sector to contribute to large institutional or government donor-funded projects, while drastically reducing the transaction costs of partnership. The first such opportunity is with the Global Financing Facility in Support of Every Woman Every Child (GFF). The GFF is a country-driven financing partnership that brings together multiple donors in support of accelerating efforts to end preventable maternal, newborn, child and adolescent deaths by 2030. Our partnership will enable the private sector to work with the World Bank to provide performance payments for GFF-linked health programs.

The GFF will potentially provide credit buyers with:

  • Up to $5 of leverage for every $1 contributed
  • Alignment with national health sector priorities through the investment case process
  • Regular reporting and third-party verification of results
  • Credibility and visibility for the presentation of achievements

This particular partnership offers a unique opportunity for the private sector to indicate priorities to the World Bank on maternal, child and adolescent health issues, as well as leverage a significant funding to help governments address the issues of vulnerable populations.

What is “pay for performance”?

“Pay for Performance” describes a payment that is made as a reward for achieving certain indicators or targets. Also known as results-based or outcome-based financing, this type of payment compliments donor financing which traditionally focuses on funding only the direct input costs associated with a program. Essentially, pay for performance rewards a result only after it is achieved rather than paying for it up front.

In the global health context, pay-for-performance has been shown to counteract dysfunctional market incentives and motivate providers to improve outcomes and strengthen health systems through a focus on results. When well-designed, performance incentives have demonstrated success at achieving improved health outcomes in both developed and developing world contexts (Performance Incentives for Global Health, Center for Global Development).

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Investing in the HCX

Why should my company invest in the Health Credit Exchange? What are the benefits of investing through the HCX?

The HCX acts as a hub for business to enhance and expand its social investment portfolio. By contributing to programs posted on the HCX, corporate partners are able to leverage the additional investments of like-minded companies to improve health outcomes in target markets. The HCX enables a company, regardless of size or location, to reduce the transaction costs of identifying and monitoring health programs, while maintaining clear visibility into the results generated by the investment through impact reporting.

Additional potential benefits to companies might include: access to global and local promotional opportunities, feature engagements at GBCHealth-sponsored or partner-led events, customized sustainability reporting, meetings with global and national leaders, in-country regulatory benefits, and/or local joint-marketing and co-branding opportunities.

Please follow this link for a downloadable copy of our current corporate deck.

Is investing on the HCX open to all companies?

All types and sizes of companies are able to invest through the HCX as long as they conform to GBCHealth’s gift acceptance policy. We do not currently accept gifts from tobacco companies. This policy aligns GBCHealth and our members fully with the policies of the World Health Organization–as well as with other important international health bodies–whose Framework Convention on Tobacco Control strictly limits interactions and partnerships with the tobacco industry. There is a $10,000 minimum requirement to contribute to the HCX at this time. Local companies and those operating in geographies where programs are implemented are especially encouraged to invest.

What are the risks of investing in the HCX?

The HCX is a philanthropic vehicle. Companies that contribute to the HCX receive a tax-benefit at the time of purchase (US companies). As such, we are unable to return funds once they are contributed. Investing in the HCX is no-risk for companies, as credits do not expire and can be re-allocated from low- to high-performing programs. The risk is transferred to the program partner, which must achieve performance targets to unlock funds. See question #10 for more information on what happens to credits if results are not achieved.

What are credits?

Credits are the vehicle for investing in programs featured on the HCX. One credit costs $1. Companies can purchase any number of credits at any time and receive a tax benefit at the time of purchase. Credits never expire and can be held in a company’s HCX account until a program and its geography is posted that matches their strategic priorities. Contributions cannot be refunded once credits have been purchased.

What type of contributions can be made through the HCX? How frequently can contributions be made? Is there a minimum contribution?

The HCX is currently only able to accept charitable donations to a US-based 501(c)(3). Donations are cash or publicly-traded securities and must be sent by credit card, check or wire transfer to our Donor Advised Fund (DAF) management partner Impact Assets using this form. All donations made by companies incorporated in the United States are tax-deductible to the fullest extent allowed by law. The minimum one-time contribution is $10,000. If you would like to set up an annual giving schedule contact Ian Matthews at . Partners on an annual giving schedule will be charged a reduced fee. For more about fees see question #7 in this section.

What happens to my contribution once it is deposited in the HCX?

All contributions made to the HCX are aggregated and held in a Donor-Advised Fund until performance metrics are achieved. Deposits in the fund are invested in socially responsible, publicly-listed securities by our partner Impact Assets. As a result, every credit purchased is effectively invested twice in social programs. Revenue from these investments, plus a three percent fee that is added at the time of credit purchase, covers the entire operational costs of the HCX. As soon as performance metrics are achieved, funds will be paid to the implementing partner(s) within 30 days. If performance metrics are not achieved, credit buyers will have the opportunity to shift credits to other programs on the HCX.

Is there a fee to invest through the HCX?

GBCHealth will add a three percent fee to all contributions made to the HCX. This fee, along with the revenue generated from investments, covers all of the HCX’s operational costs.

My company is interested in contributing towards one or more specific programs on the exchange, how can we do this?

Companies interested in supporting a program through the HCX are encouraged to view our website for updates. We are currently building a web-based platform to host the Exchange and accept contributions directly. In the meantime, you may contact Ian Matthews, Director of Innovative Finance at to learn more about available opportunities and how to get involved.

Can my company fund a program through the HCX which uses our own technology or products?

Yes. A credit buyer has full discretion over how to use their credits once they are purchased. If you are interested in posting a program to the HCX, GBCHealth’s innovative financing team will work with you on a concept note and help develop indicators before the program goes through the due diligence and Investment Committee review process. Corporate programs and their preferred implementing partners will be subject to the same due diligence requirements as other partner programs. It is expected that corporate partners will provide anchor funding commitments to any programs they recommend for listing on the Exchange.

What happens to credits if results are not achieved?

The HCX is a results-based financing program. As such, if no results are achieved within the milestone timeline, program partners will receive no payment. If partial results are achieved within the milestone timeline, they will receive only partial payment. In either situation, credit buyers will have the opportunity to shift unused credits to other programs featured on the HCX.

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Program Questions

Is there a required health focus for programs to be listed on the exchange? For example, communicable diseases, NCDs, health-systems, etc.

No. Programs posted on the Exchange can focus on a breadth of health issues. However, the HCX will prioritize issue areas based on the guidance of our Advisory Committee. As part of its recently launched partnership with the Global Financing Facility, GBCHealth will initially focus on programs that improve the health of women and children. However, this does not preclude any other programs or health areas from being listed on the Exchange. In general, the purpose of the HCX is to align capital with innovation in program design and the integrated delivery of high quality products and services across verticals. GBCHealth will occasionally put out requests for proposals (RFPs) around certain issue areas that are deemed to be a priority by HCX management and the Advisory Committee.

How are program priorities identified?

Program priorities are informed by our Advisory Committee, which is comprised of a representative group of global health experts from the private, public and NGO sectors.

How can my organization apply to have a program listed on the HCX?

If you are interested in listing a program for funding on the Exchange we accept concept notes all year-round. Please see the linked program partner manual to learn more about the process and our current priorities. While programs can cover a range of health issues, GBCHealth will initially focus on programs that improve the health of women and children. Other programs will be innovative in design and will prioritize the integrated delivery of high quality products and services across verticals.

Organizations and companies interested in listing a program on the HCX are encouraged to contact Ian Matthews, Director of Innovative Finance, GBCHealth at to learn more about posting a program.

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HCX Process

How are programs and implementers vetted before being offered on the Exchange?

Partners and their programs go through an extensive due diligence process before they are featured on the HCX. This process includes concept note submission and metric development, document review (legal registration, program award letter, audited financials), review of prior examples of output/outcome monitoring and Investment Committee approval. Once approved, GBCHealth will confirm anchor funding commitments of at least 50 percent of the program’s total cost before the program is eligible to be posted publicly on the HCX. For more specifics about due diligence timeline and approval process please see the linked program partner manual.

How are program results audited?

Program results are monitored and tracked by the program partner and reported quarterly to GBCHealth. Depending on the program, results are verified and audited by a local third-party at the program level in real time or later on an aggregated basis. For many HCX programs, metrics are being tracked and audited by the donor (e.g. USAID, Gates, World Bank) as part of the initial donor-funded program. In this case, GBCHealth will seek to piggyback on existing auditing infrastructure to add our particular indicators.  Verified results will trigger the release of a payment based on the level of performance. Results for each indicator will be reported to credit buyers annually with modelling performed to estimate impact.

How are incentive payments used by the implementers once results are achieved?

GBCHealth does not stipulate how a partner should or should not use incentive payments. HCX catalytic grants allow a partner to invest in essential assets, not covered by their input funding, including facility upgrades, advanced stockpiling of products, training for providers, testing innovative service delivery models and/or creating performance bonus structures for health workers. All of these investments enable a partner to accelerate results and transition more effectively to scale. Program partners have a strong incentive to invest further in improving program outcomes as future payments are dependent on progress year or year toward an ultimate performance target.

Monitoring and reporting will continue one year or more beyond the close of the program to track how funds have been used. This gives the partners an opportunity to later evaluate the effectiveness of the performance-based grants.

How frequently are impact reports made available?

Results are reported by the program partners to GBCHealth quarterly and can be made available to credit buyers upon request. All credit buyers receive annual Impact Reports which contain information on actual results measured for each indicator as well as modeled impacts based on the number of credits used.

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Margaret ArbogastThe Health Credit Exchange: Frequently Asked Questions