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Increasing Benefits to Communities


Promising health care delivery and payment reforms are under way that may have contributed to the slower rates of growth in health care spending seen in recent years. Delivery reform alone, however, is unlikely to slow cost growth over the long run: it is important to address the social, economic, and envi- ronmental determinants that contribute to the increasing burden of poor health and chronic illness. Other industrialized countries that achieve better population health pursue more balanced investment strategies that recognize the contributions of the full set of health determinants.1 Building on these insights, multistakeholder initiatives have been established in many US regions to coordinate multisector invest- ments and activities focused on improving population health. Whether these will succeed locally or spread sufficiently across the country remains far from certain.2 In this Viewpoint, we suggest that a modest reorientation of hospital community benefit programs could help accelerate the development of successful regional health improvement initiatives…


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