Accountable communities of health, health and social service systems alignment, and population health: Eastern Washington State, 2017-2019

Objectives. To assess health system transformation and alignment in the Better Health Together (BHT) accountable community of health (ACH) region of Eastern Washington.

Methods. This trend study leveraged cross-sectional data collected in 2017 and 2019 in Eastern Washington. A total of 165 responses from individuals representing 112 organizations were collected in 2017, and 211 responses from individuals representing 92 organizations were collected in 2019. More than one third (38%; n = 35 organizations) of cases overlapped between the 2 samples. Implementation of the ACH model is the exposure. Outcomes of interest included indicators of system transformation and alignment.

Results. Organizations throughout BHT’s region became more engaged, less siloed, and better connected from 2017 to 2019. At least some of the increased connectivity observed was directly attributable to the role BHT played in facilitating the creation or maintenance of interorganizational relationships across Eastern Washington.

Conclusions. The ACH model is a promising approach to aligning health and social service systems for population health improvement. Evidence shows that ACH organizations can serve as trusted conveners able to facilitate interorganizational relationships across sectors.