Prevention Institute’s health systems transformation efforts focus on broadening out the definition of the health system to include all the organizations and sectors that contribute to people’s health. The health system in the United States is typically thought of as the network of hospitals, health plans, and community health centers where people receive clinical care. But the system that supports thriving and equitable communities is far broader. During the COVID-19 pandemic, public health agencies and the work they do to support community health, safety, and wellbeing were thrust into the spotlight. Community-based organizations also play a crucial role: during the pandemic, they provided food, financial support, eviction protection, ways to maintain social connection, and other basics that communities need in order to be healthy.

PI advocates for improved integration of all the elements of the system, increased financial support to keep the system stable, and changes to aspects of the system that are perpetuating health inequities and racial injustice. We collaborate with health system partners and to redesign and augment the existing system so that it prioritizes improved health outcomes for communities of color, immigrants, communities with low incomes, and other groups that the health system has previously neglected.

Health Systems Transformation > Content Buckets
Health Systems Transformation > Content Buckets
Health Systems Transformation > Content Buckets

What is an ACH? 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.

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This fact sheet provides a snapshot of our recently published paper, Disrupting the Pathway – A Prevention Approach to Medical High Utilization. Disrupting the Pathway describes an exploratory methodology for addressing high utilization by applying a community-wide prevention lens. The rich body of prevention research, practice, and experience supports the notion that this approach can add value to existing efforts being undertaken by the healthcare system. Prevention can reduce the pipeline to high utilization, support the maintenance and restoration of health and wellbeing, and improve the

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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.

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Prevention Institute provides support to the BUILD Health Challenge—a unique coalition of national and regional funding organizations--designed to encourage communities to develop meaningful partnerships among hospitals and health systems, community-based organizations, local health departments, and other organizations to improve the overall health of local residents. The goal of the BUILD Health Challenge is to identify, accelerate, and spotlight best practice models and innovative approaches that reorient the field toward upstream factors that influence health.

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.

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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.

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Community leaders across the country are exploring the Accountable Communities for Health (ACH) model as an innovative opportunity to pursue population health improvement and health equity. The core of the ACH approach is harnessing the collective efforts of health stakeholders including healthcare, public health, behavioral health, school districts, other governmental entities, and community- and faith-based organizations. The success of this type of approach has been demonstrated repeatedly over the last 50 years through health improvement efforts that have incorporated both individual

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This fact sheet addresses basic questions about the Community-Centered Health Home (CCHH) model, including what a CCHH is, why healthcare organizations should consider implementing the model, and what we've learned from pilot sites across the country.

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