A National Academy of Medicine discussion paper by three Health Policy and Management faculty and staff members identifies a common set of principles driving the growing number of initiatives promoting Accountable Communities for Health to improve population and community health. The research team, including Research Assistant and Department of Health Policy and Management student Marie Mongeon, Professor Jeffrey Levi, and Research Professor Janet Heinrich, reviewed both peer-reviewed, published articles and gray literature on the movement, which is inspired by the increasing recognition of the need to address the underlying root causes of poor health outcomes, rather than simply providing treatment.
The discussion paper points out that the Affordable Care Act of 2010’s emphasis on value-based payment models was a major driver for the accountable health movement. The resulting accountable health initiatives embrace the concept that a shared responsibility exists for the health of a community or patient population across sectors. The authors say that a growing body of evidence suggests that the success of value-based payment models will be closely tied to efforts addressing the behavioral, social, economic, and environmental determinants that play a key role in health inequities and poor health outcomes.
The authors stress that we are in the early days of accountable health initiatives, focusing on establishing the principle of accountability for a community’s health and applying it to the multiple sectors that contribute to health. But the common set of principles identified in their new discussion paper suggests that these principles are taking promising steps towards achieving the Triple Aim: the belief that to achieve health care delivery system reform, interventions must focus on reduction of health care costs; improvement of patient-centered health care experiences (including quality of care); and improvement in population health.