Transformation in Action: How Accountable Communities for Health Promote Collaboration, Systems Change and Health Equity

CACHI’s 2017-2022 Evaluation Report | Authored by CACHI’s Evaluation Team—Desert Vista Consulting, AGD Consulting and the Center for Outcomes Research and Education

This report is a comprehensive analysis of the first five years of ACH implementation in California. It offers ten key insights on how to successfully launch and grow an ACH gleaned from the experiences, successes and challenges of the first 13 ACHs launched in the state. These findings help inform future ACH implementation as the model scales and spreads to other geographies within California and nationally.

At its core, CACHI is a systems change initiative aiming to transform and align norms, practices, and policies to improve health equity and long-term population health outcomes. Because systems change work is developmental, complex and takes time, a key aspect of the evaluation was to track both progress toward, and achievement of systems changes across the sites.

Over the last five years, ACHs made demonstrable progress in solidifying the core ACH model elements necessary for creating the conditions for longer term systems changes. Key markers for progress toward systems changes include: enhanced knowledge, strengthened relationships, increased individual and organizational capacity, and strengthened champions and community ownership. Moreover, ACHs achieved actual systems changes related to transformed norms, changes in practices within and across partners, securing new and sustainable funding mechanisms, and advancing policy changes.