For decades, health policy debates in Washington were guided by a relatively stable set of inside-the-Beltway insiders: lobbyists, trade associations, think tanks, congressional staff, and government experts. Influence flowed primarily through these traditional channels, with institutional players acting as the gatekeepers of policy ideas and legislative outcomes.
That dynamic has not disappeared. Traditional institutions remain central to the health policy ecosystem. But they no longer hold a monopoly on how influence is built, amplified, and translated into action.
A Multidirectional Model of Influence
In today’s environment, new voices and leaders have emerged operating across three interconnected dimensions:
- Mobilizing influence: driving grassroots energy, activating constituencies, and shaping primary electorates through digital platforms and community organizing.
- Amplifying influence: reinforcing narratives across an expanded media environment of podcasts, digital outlets, and online personalities who serve as validators and message carriers.
- Channeling influence: directing this momentum into institutional arenas–candidate recruitment, campaign staffing, legislative offices, and even executive branch appointments.
This new model shows how influence now circulates dynamically, rather than moving only in one direction. The result is a more multidimensional and dispersed architecture of policy engagement.
A Changing Profile of Leadership
The individuals driving these flows often look very different from the traditional Washington insider. Many emerge from local leadership roles, issue-specific activism, or online networks, yet they exercise national impact.
Consider, for example, the profile of a new voice in today’s health policy landscape. Imagine a small business owner in a Midwestern county who first entered politics during the pandemic. Motivated by concerns about federal overreach, he built credibility by speaking directly to his neighbors and cultivating an online following that engaged with health care debates. Through mobilizing influence, he organized grassroots supporters and helped shape a competitive primary against the incumbent. Through amplifying influence, his voice gained traction in regional radio and national podcasts, reinforcing narratives among key audiences. And through channeling influence, he played a role in recruiting candidates, staffing offices, and even influencing federal agency appointments.
Though far from Washington, his reach now extends into Congress, the media ecosystem, and the executive branch. He is just one example of how new voices and leaders are reshaping the way health policy influence operates today.
Implications for Health Policy
For health care stakeholders, this shift requires a new approach. Advocacy campaigns must anticipate not only how ideas are received inside Washington but also how they mobilize communities, are amplified through digital channels, and are ultimately channeled into governing institutions. In this environment, understanding influence requires a multidimensional lens that integrates grassroots, narrative, and institutional dynamics.
Introducing Influence360
To meet this need, Reservoir has developed Influence360, a new framework for analyzing the multidirectional flows of today’s influence environment. Built on extensive research of nearly 5,000 congressional primary voters, Influence360 helps stakeholders map how influence mobilizes, amplifies, and channels across the political ecosystem. Launched alongside our PRISM audience intelligence platform that identifies sixteen new segments within the base of both political parties, Influence360 provides clients with a unique vantage point: not only identifying who the key audiences are but also understanding how influence moves through them.
In today’s fractured and fast-moving environment, the ability to recognize and adapt to this multidirectional flow of influence is no longer optional—it is essential for shaping the future of health care policy.