Accountable Communities of/for² Health (ACHs) are “community-based partnerships formed across sectors such as health care, housing, social services, public health, employment training and economic development to focus on a shared vision and responsibility for the health of the community.”¹

ACHs function as independent nonprofit organizations or initiatives housed in backbone organizations like hospitals or local health departments, with staff dedicated to facilitating the ACH’s collaborative work.
ACH partners include cross-sector organizations, community members, local coalitions, government agencies, sovereign tribal nations, municipalities, private foundations, and more.
ACHs work locally, sometimes focusing on neighborhoods within a city that have the greatest disparities like the West Sacramento Accountable Community for Health Initiative in California (CA) and other times focusing on multi-county regions like the North Central Accountable Community of Health in Washington (WA). Many ACHs focus on a single county, like Hope Rising Lake County in CA or Elevate Health in WA.
ACHs were created as early as 2014. As of 2023, the ACH model has been adopted by five states including CA, Minnesota, Texas, Vermont, and WA.
States established ACHs through state legislation, Medicaid waivers, and/or support from private foundations as a strategy to transform health systems.
ACHs focus on improving many different types of health outcomes, ranging from focused health conditions like addressing asthma to broad outcomes like improving health equity.
While every ACH is different, common elements exist across them.³ Central to these elements is equity, which is a focus area for most ACHs. Figure 1 shows the essential elements of ACHs, as defined by the Funders Forum on Accountable Health. Notably, equity spans the model and applies to each essential element.
ACHs can be sustained over time as one approach to collaboratively governing a community’s health system.⁴

Figure 1: Essential Elements of ACH²⁰

Related Resources

Accountable Communities of/for Health: Transforming Health Systems through Dedicated Multisector Collaboration, a Population Health Innovation Lab (PHIL) research brief (2023)
Powering Change Curriculum: Building Healthy, Equitable Communities Together, a Population Health Innovation Lab (PHIL) and California Accountable Community for Health Initiative (CACHI) curriculum for multisector collaboratives (2021)
Accountable Community for Health (ACH) Start Up Guide, a Population Health Innovation Lab (PHIL) guide (2019)
ACH Resource Inventory, a Population Health Innovation Lab (PHIL) inventory (2020)
Inventory of Accountable Communities for Health, a Funders Forum on Accountable Health inventory
Developing a Framework To Measure the Health Equity Impact of Accountable Communities For Health, a Funders Forum on Accountable Health report
Advancing Equity: Adapting to Local Context and Confronting Power Dynamics. Lessons Learned from Accountable Communities of/for Health, a Population Health Innovation Lab (PHIL) report (2022)
Advancing Equity: Adapting to Local Context and Confronting Power Dynamics, a Population Health Innovation Lab (PHIL) web discussion (2022)
Keeping the Focus on Equity with ACHs, a Population Health Innovation Lab (PHIL) research presentation (2021)
ACHs are Key Players in Improving Community Health During COVID-19 Pandemic, a Population Health Innovation Lab (PHIL) research presentation (2021)
Aligning Systems for Health with ACHs Research Update, a Population Health Innovation Lab (PHIL) research presentation (2021)

View all references for the Data Walk.