title: Moving toward implementation: the potential for accountable care organizations and private-public partnerships to advance active neighborhood design.
abstract: The 2010 Affordable Care Act's (ACA) aims of lowering costs and improving quality of care will renew focus on preventive health strategies. This coincides with a trend in medicine to reconsider population health approaches as part of the standard curriculum. This intersection of new policy and educational climates presents a unique opportunity to reconsider traditional healthcare structures. This paper introduces and advances an alignment that few have considered. We propose that accountable care organizations (ACOs), which are expected to proliferate under the ACA, present the best opportunity to establish partnerships between healthcare, public health, and community-based organizations to achieve the legislation's goals. One example is encouraging daily physical activity via built environment interventions and programs, which is recommended by numerous groups. We highlight how nonprofit organizations in Sacramento, California have been able to leverage influence, capital, and policy to encourage design for active living, and how their work is coordinating with public health and healthcare initiatives. In conclusion, we critically examine potential barriers to the success of partnerships between ACOs and community organizations and encourage further exploration and evaluation.
authors.affiliation: Pacific Brain and Spine Medical Group, Sutter Health East Bay Neuroscience Institute, Eden Medical Center, 20055 Lake Chabot Rd., Suite 110, Castro Valley, CA 94546, United States. Electronic address: zusmane@sutterhealth.org.
authors.forename: Edie E
authors.initials: EE
authors.lastname: Zusman
authors.affiliation: College of Environmental Design, University of California Berkeley, 202 Wurster Hall #2000, Berkeley, CA 94720-2000, United States. Electronic address: secjensen@berkeley.edu.
authors.forename: Sara Jensen
authors.initials: SJ
authors.lastname: Carr
authors.affiliation: Sacramento County, 827 7th Street, Room 230, Sacramento, CA 95814, United States.
authors.forename: Judy
authors.initials: J
authors.lastname: Robinson
authors.affiliation: Sacramento County, 7001-A East Pkwy, Suite 600, Sacramento, CA 95823, United States.
authors.forename: Olivia
authors.initials: O
authors.lastname: Kasirye
authors.affiliation: Hospital Quality Institute, 1215 K Street, Suite 800, Sacramento, CA 95814, United States.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Zell
authors.affiliation: California Department of Public Health Office of Health Equity, 1615 Capitol Avenue, Sacramento, CA 95814, United States.
authors.forename: William Jahmal
authors.initials: WJ
authors.lastname: Miller
authors.affiliation: WALKSacramento, 909 12th Street, #203, Sacramento, CA 95814, United States.
authors.forename: Teri
authors.initials: T
authors.lastname: Duarte
authors.affiliation: Echelon Transportation Group, 2523 J Street, Suite 204, Sacramento, CA 95816, United States.
authors.forename: Adrian B
authors.initials: AB
authors.lastname: Engel
authors.affiliation: Sacramento Area Council of Governments, 1415 L Street, #300, Sacramento, CA 95814, United States.
authors.forename: Monica
authors.initials: M
authors.lastname: Hernandez
authors.affiliation: 2025 S Street, #203, Sacramento, CA 95811, United States.
authors.forename: Mark B
authors.initials: MB
authors.lastname: Horton
authors.affiliation: The Advisory Board, 23 Geary Street, Suite 300, San Francisco, CA 94108, United States.
authors.forename: Frank
authors.initials: F
authors.lastname: Williams
mesh_terms: D060866:Accountable Care Organizations; D002140:California; D003159:Community-Institutional Relations; D003299:Cooperative Behavior; D004779:Environment Design; D006293:Health Promotion; D006801:Humans; D007373:Interinstitutional Relations; D009043:Motor Activity; D009939:Organizations, Nonprofit; D058991:Patient Protection and Affordable Care Act; D011635:Public Health Administration; D015980:Public Health Practice; D055818:Public-Private Sector Partnerships; D014481:United States
keywords: Accountable care organizations; Communities; Environment; Patient Protection and Affordable Care Act; Public health