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Financing the infrastructure of accountable communities for health is key to long-term sustainability

D.L. Hughes, C. Mann
Health Affairs

Accountable Communities for Health (ACHs) are collaborative partnerships spanning health, public health, and social services that seek to improve the health of individuals and communities by addressing social determinants of health such as housing, food security, employment, and transportation. ACHs require funding not only for programs and services but also for core infrastructure functions. We conducted a legal and policy review to identify potential funding streams specifically for ACH infrastructure activities. We found multiple and credible options at the federal and state levels and in the public health, health insurance, and philanthropic and private sectors. Such options could support ACH infrastructure directly or through reimbursement for administrative costs associated with programmatic work. Yet we also found that there is no dedicated or explicit source of funding for these critical functions. For sustainable and long-term ACH support, policy makers and program administrators should clarify and define ACH infrastructure functions and, where appropriate, explicitly recognize supporting these functions as an allowable use of funds and facilitate their coordination across program funding streams.

Hughes DL, Mann C. Financing the infrastructure of accountable communities for health is key to long-term sustainability. Health Aff (Millwood). 2020;39(4):670-678. doi:10.1377/hlthaff.2019.01581

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Publication year
Resource type
Peer Reviewed Research
Social Determinant of Health
Housing Stability
Study design
Other Study Design