In addition to health insurance coverage expansions, the Affordable Care Act and related federal and state reforms have ushered in an era of new resources and incentives for hospitals, insurers and other organizations to engage in community-wide efforts to improve health. These incentives include enhanced hospital community benefit requirements, adjusted medical loss ratio requirements for health insurers, value-based payment models for providers, tax incentives for employers, and direct federal funding through the Prevention and Public Health Fund. Relatively little is known about how healthcare and community organizations have responded to these policy changes and their interaction with coverage expansions. This study follows a national cohort of U.S. communities during 2006-18 to (1) estimate changes in public health spending and multi-sector alliances that support population health activities in the post-ACA era; (2) identify ACA-related policies associated with changes in alliances and spending across states and communities; and (3) explore how coverage expansions may interact with other ACA-related policies in shaping multi-sector alliances and contributions to population health activities. This research is supported collaboratively by Altarum’s RWJF-sponsored Research to Advance Health Reform program and the RWJF Systems for Action program.
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Lexington, KYUnited States