Achieving accountability for health and health care

There is no well-established mechanism at the local level to discuss or manage the balance of investments in health care and the other social determinants of health. We propose the development of voluntary regional organizations and/or use of current organizations to work with stakeholders of the health system to 1) review local data on health, experience and quality of care, and costs of care (Triple Aim); 2) create shared goals, actions and investments to meet the Triple Aim; and 3) involve citizens in local delivery system reform and stewardship of financial resources. These accountable health communities (AHCos) would contribute to co-creating a sustainable health system.