A regional home base for healthier Washington communities
Meeting community health needs at scale requires a collaborative regional presence that no single clinic or agency can provide. Accountable Communities of Health (ACHs) support cross-sector partners and systems like healthcare, social services, community and public health to work together to improve health and regional well-being.
What are Accountable Communities of Health?
ACHs are independent, regional organizations that bring together health care, public health, social services, Tribal partners, schools, and local government to improve community health.
Trusted, neutral conveners
ACHs have a long history of building partnerships, convening community and translating state policy into local action.
Strategic, responsive problem solvers
ACHs work collaboratively with local partners on community health challenges. Their trusted and robust networks can also address emerging health and regional crises including flooding, pandemic response, the overdose crisis and impacts to Medicaid and SNAP due to federal changes.
System-aligners
ACHs address fragmented systems and siloed funding, align clinical care, public health, social services, and community prevention.
History of Accountable Communities of Health
Since their inception in 2017, Washington’s nine regional Accountable Communities of Health (ACHs) have come together to share, learn from one another, and work to improve the lives of people in their local communities and across the state.
By prioritizing regional and local issues, ACHs bring together cross-sector partners to make locally driven investments and improvements in healthcare and community well-being.
In 2022, ACH leadership formalized cross-ACH partnership and collaboration by establishing the Coalition of ACHs: a shared association for advancing the work of regional ACHs together
Regional health networks convened to address local needs with community decision-making. That structure defined the future of ACHs. In 2015 CHOICE and North Sound were created as pilots.
Nine ACHs established to address the health needs in their region. Medicaid Transformation Phase 1: ACHs built regional infrastructure and formalized cross-sector partnerships.
Medicaid Transformation Phase 2: Community Care Hubs launched across all regions.
During the COVID-19 pandemic, ACHs mobilized emergency response and conducted community outreach. CACH established.
Medicaid Transformation Phase 2: Community Care Hubs launched across all regions.
Local governance
ACHs honor local governance and community expertise so that local culture, language and priorities are lifted up — from urban neighborhoods to rural communities.
Each ACH’s governance structure is multi-sector and includes community voice. Each ACH board has designated seats for local government, local health department leaders, local healthcare providers, and community leaders.
This governance model allows ACHs to surface and act on priorities that matter locally — such as rural behavioral health access, culturally specific services, or place‑based housing stability efforts — rather than imposing a one‑size‑fits‑all statewide program. ACHs turn diffuse organizations into structured, ongoing collaboration, so regional partners can move from reacting to issues to proactively shaping a healthier, more effective local system.
Grounded in evidence
Evaluations have found that Washington’s ACHs and similar models across the country have had significant community-level impact.
ACHs strengthen cross‑sector collaboration, increase community voice in decision‑making, and improve coordination between clinical care and social services. They also help align local priorities and increase communities’ ability to act in a coordinated fashion.
National reviews, including the federal Accountable Health Communities evaluation, also link similar efforts to improvements in specific outcomes like avoidable emergency department use for some high‑need groups. These evaluations conclude that ACH‑style approaches are a promising way to build lasting, community‑driven infrastructure for better health.
ACHs in action
Elevate Health One Pierce Social Impact Fund: Flexible funding for stronger communities
One Pierce, Elevate Health's social impact loan fund, offers low-barrier, low-interest financing to mission-driven organizations working to improve health and wellness in Pierce County.…
CHOICE ABCD Program: Supporting children’s oral health
Access to Baby & Child Dentistry (ABCD) connects Medicaid covered children ages 0-6,and children up to age 12 with a Developmental Disabilities Administration (DDA)…
SWACH Overdose Prevention: Improving access to life-saving supplies
When SWACH’s Community Health Improvement (CHI) department received Health Resources and Services Administration (HRSA) RCORP-Overdose Response funding in 2025, it marked more than a…
How ACHs support state agency initiatives
Depending on the needs of their region, ACHs often partner on state agency initiatives.
Department of Corrections reentry program
ACHs connect returning community members to housing, behavioral health, and social services — reducing recidivism and supporting successful reintegration.
Department of Health public health priorities
ACHs extend DOH’s reach on chronic disease prevention, maternal and child health, and vaccination access through trusted community networks.
Department of Children, Youth & Families child welfare
ACHs support families involved in the child welfare system with wraparound services including social care, including social care and housing stability.
Health Care Authority MTP 2.0
ACHs play an integral role in Washington’s Medicaid Transformation Project (MTP 2.0) efforts, and partner with the Health Care Authority to support delivery of services. ACHs manage their own regional Community Care Hubs to connect individuals with health care and health-related social services.
Department of Commerce housing initiative
ACHs partner to support housing stability and community behavioral health.
Department of Agriculture
ACHs are partnering with the Washington State Department of Agriculture (WSDA) to strengthen regional food access and better connect communities to the state’s hunger-relief system. The work emphasizes listening to communities, strengthening partnerships with food and hunger-relief organizations, and identifying opportunities to make food resources more accessible and responsive across Washington.
How ACHs are funded
ACHs are independent 501-c-3 organizations, accountable to the regions and communities they serve. ACHs operate by braiding funding and contract opportunities from federal, state, county, local government, and private funders to sustain and expand whole-person care across Washington.
ACHs play an integral role in Washington’s Medicaid Transformation Project (MTP 2.0) efforts, and partner with the Health Care Authority to support delivery of services. ACHs manage their own regional Community Care Hubs to connect individuals with health care and health-related social services.
State agency partnerships
Multi-agency contracts fund targeted programs across health, behavioral health, child welfare, and reentry.
Regional contracts
ACHs partner with local governments, regional health care providers and other partners to meet the needs of their communities.
Public-private partnerships
ACHs contract with a government agencies and private-sector organizations to develop systems and infrastructure to serve communities.
Find your regional ACH.
Every region of Washington has an ACH rooted in local partnerships, priorities, and community needs. Find the one closest to you.