Traditionally, responses to crises and societal problems--the Covid-19 pandemic, natural disasters, racial inequities--are considered the responsibility of the public sector and NGOs. But addressing the world's most critical problems requires leadership, resources, and skills beyond those of any single organization, industry, sector, or government. What's needed, the authors argue, is high-impact coalitions--an emerging organizational form that reaches across boundaries of business, governments, and NGOs. Although public-private partnerships have existed for some time in various forms, large cross-sector, multistakeholder initiatives are newly resurgent and not yet widely understood. They are more voluntary and relationship-based than formal organizations but more task-directed than networks. They connect otherwise disparate spheres of activity that bear on big problems by aligning powerful actors behind a purpose-driven mission. Once underway, they can harness and utilize capabilities quickly and flexibly. This article describes the features of high-impact coalitions and sets out five principles that make the difference between success and failure.

In 2021, new CEO Karen Lynch (named the most powerful woman in business) considered the next transformation phase for CVS Health (a Fortune 5 corporate giant. The 2018 acquisition of Aetna insurance brought her to the company as part of its long evolution from a pharmacy chain to a multi-faceted health benefits and services provider. The COVID-19 pandemic accelerated innovation and improvisation, with quick launching of testing and, later, vaccination, as well as new products, services, and in-store clinics. Now the question was how to continue transforming itself and health care delivery in America.