Accountable Communities for Health: Moving From Providing Accountable Care to Creating Health

Abstract

Lessons from community-oriented primary care in the United States can offer insights into how we could improve population health by integrating the public health, social service, and health care sectors to form accountable communities for health (ACHs). Unlike traditional accountable care organizations (ACOs) that address population health from a health care perspective, ACHs address health from a community perspective and consider the total investment in health across all sectors. The approach embeds the ACO in a community context where multiple stakeholders come together to share responsibility for tackling multiple determinants of health. ACOs using the ACH model provide a roadmap for embedding health care in communities in a way that uniquely addresses local social determinants of health.

The Importance of Interprofessional Practice and Education in the Era of Accountable Care

“…This "panel" population health is different from "geographical" population health, which reaches out to all patients in a set region and aims to address social determinants of health and needs at a community level. The ideal ACO model is a blend of both, with a move toward what is called an accountable community of health [11,[12][13][14][15]. Additionally, reaching out to patients in their environment rather than waiting for them to come to the office is a significant change for team members, and not all team members are comfortable with this shift.…”

A Community-Wide Collaboration to Reduce Cardiovascular Disease Risk: The Hearts of Sonoma County Initiative

“…Implementing these clinic/community strategies successfully often requires multi-sectoral collaborations that bring together a broader range of organizations and institutions than are part of typical public health coalitions (2). For example, multi-sector Accountable Communities of Health have been part of many State Innovation Model (3) health improvement projects that are attempting to bring together a range of partners to work on health system transformation (4). …”

Accountable Care Communities

“…ACCs work to leverage the contributions of all members by strengthening links between existing programs and services, and coordinating resources and efforts. ACCs bring together traditional health care, with its focus on preventing and treating illness, with nontraditional partners, whose focus is on creating the conditions necessary for good health [2].…”