ACA and implications for improving population health: Opportunities to move beyond the clinical

The Affordable Care Act has created opportunities for health care delivery and public health practice to collaborate in new ways to improve population health, and some of the law’s provisions offer concrete platforms for better interaction between the two fields.  These opportunities complement system transformation already undertaken by a number of communities often in partnerships involving health care organizations and one or more of the following: state or local public health agencies, academic institutions, and community or other non-profit organizations. In a June 2013 workshop of the IOM Roundtable on Population Health Improvement, presenters and participants discussed: the emergence of variants of the accountable care organization concept, such as accountable care communities in Ohio and coordinated care communities in Oregon, and the need to create markets for health, drawing investments that keep people from entering the care system. Workshop participants also learned about and discussed: the role of communities in shaping the health system broadly conceived (and not merely health care systems); the ACA-driven or reinforced efforts to change the health care payment system and incentivize primary prevention and a population focus; and the increased involvement of non-profit hospitals in partnership with public health agencies and others to tackle some of the place-based factors (housing quality, educational attainment) that powerfully influence the health of their communities.