Obamacare was passed, in part, to control the imbalance between the nation's high health spending and poor health outcomes.  The law includes several provisions that enhance coordination between health care delivery and public health systems to help improve overall health in the population while lowering costs.  To that end, it gives states new funding to support community-based interventions that can be replicated nationally if they prove effective.

A new report from the National Academy for State Health Policy and ChangeLab Solutions profiles how eight states—California, Maryland, Massachusetts, Minnesota, North Carolina, Oregon, Texas, and Vermont—have successfully used this provision in combination with existing state programs to improve care and reduce costs. These efforts show how important state initiatives can be in improving health care.

The report highlights three types of strategies that states have used to take advantage of the Obamacare assistance.  The have implemented innovations in their Medicaid programs through waivers of federal requirements.  They have encouraged experiments with delivery system reforms, such as accountable care organizations. And they have pushed non-profit hospitals to be more responsive to community needs.

These approaches are not all new. However, new funding and regulatory powers under health reform have given states new tools for implementing them. Most people think of Obamacare in terms of its primary goal of expanding individual access to coverage. But other aspects of the law, like support for state-supported initiatives such as these, may be more important in bringing about effective and transformative changes in the health care system.