Health Delivery and Payment Transformation

An Accountable Community for Health (ACH) is a structured, cross-sectoral alliance of healthcare, public health, and other organizations that plans and implements strategies to improve population health and health equity for all residents in a geographic area. Designed to strategically leverage resources across sectors, the ACH model presents tremendous opportunities to reduce costs, enhance quality of care, and improve population health.

PI is actively analyzing how an upstream, community-level prevention approach can reduce and prevent frequent utilization of high-cost healthcare services.

Prevention Institute is actively exploring alternative payment models and how these models can fund community prevention and support population health and equity. 

An Accountable Community for Health is a structured, cross-sectoral alliance of healthcare, public health, and other organizations that plans and implements strategies to improve population health and health equity for all residents in a geographic area.

The Accountable Community for Health model is emerging as a promising vehicle toward reaching the full potential of the Triple Aim-particularly efforts to improve population health. Accountable Communities for Health: Opportunities and Recommendations, Prevention Institute's report for the state of Vermont, presents research and analysis conducted by Prevention Institute to inform the potential development and application of the Accountable Community for Health (ACH) model.

The Accountable Community for Health (ACH) model provides a powerful opportunity for healthcare institutions to prepare for the collaborations necessary to succeed in this new health ecosystem. This brief outlines the ACH model, provides examples of relevant collaborations emerging throughout the country, and recommends several concrete actions for organizations interested in taking the next step toward adopting the ACH approach.

Disrupting the Pathway explores a primary prevention approach to reduce frequent utilization of high-cost healthcare services and includes model strategies that healthcare organizations and their community partners can collectively implement to improve community conditions that have a role in producing high utilization and subsequent costs. 

Published by the Institute of Medicine’s Roundtable on Population Health Improvement, Closing the Loop outlines some of the essential elements of sustainable funding mechanisms and argues that we need to “close the loop” by ensuring that when prevention efforts DO save money, substantial portions of that money get plowed back into prevention.  

Prevention Institute researchers talked to health-system innovators around the country to identify emerging new approaches. The pioneers we profile in this report have found surprising new ways to capture funds already in the healthcare system and redirect them to pay for population health measures that prioritize community prevention.

This report was produced following a series of interviews with subject matter experts chosen for their experience with prevention and public health initiatives and their expertise in creating dedicated funding streams for prevention.

As one of eight communities in the California Accountable Communities for Health Initiative, the East San Jose Peace Partnership has used ACE|R as its overarching framework. This emphasis has helped the project to remain focused on community level change strategies and provided a structure for expanding its focus to address multiple forms of violence.

Across the country, health providers and public health leaders are challenging the old ways of delivering health services by developing cutting-edge strategies to improve the health of their communities and their patients by addressing underlying community conditions.