Public Health Transformation

Welcome to NACCHO's Public Health Transformation page. Here, you will find all of our best resources on transforming your LHD into a more effective organization.

If you have any questions or concerns, please email us at info@naccho.org.


This webinar, featuring Econometrica and NACCHO, demonstrated a tool designed to help local health departments make strategic decisions about how to improve health outcomes based on community needs and resources. Currently, many local health departments are asking "should I continue to provide clinical services?" While the answer may be different in each community, this tool is a first step in helping local health departments demonstrate relationships between behaviors, health outcomes, health system resources, and social/economic status. 

Please CLICK HERE to find the slides, and HERE for the recording.

NACCHO formed the Public Health Transformation Sentinel Network (Sentinel Network) in the fall of 2014 to collect information and feedback regarding the role of LHDs in the transformation of the local public health system, including implementation of the ACA. Members of the Sentinel Network are familiar with local-level ACA implementation efforts across their state or region and have general knowledge about LHDs and their roles in the public health and health care systems. Sentinel Network members participate in regular surveys and conference calls designed to explore a number of ACA-related factors at the local level, including the extent of implementation, facilitators and barriers to implementation, and innovative implementation strategies.

Sentinel Network Survey Results

The Affordable Care Act (ACA) lays the groundwork for a substantial increase in the number of people who will have access to health insurance through either Medicaid expansion or the Health Insurance Marketplace. States are now tasked with reaching out to and enrolling newly eligible persons. State and local public health departments are often trusted entities in the community and can leverage resources and data to facilitate outreach and enrollment. In 2014, RAND and NACCHO conducted an environmental scan, key informant interviews, and site visits in order to explore innovative models and best practices for local health departments engaged in outreach and enrollment. This series of case studies and publications describes seven innovative models with a focus on the unique role of local health departments and their leadership.

Case Studies

The Affordable Care Act (ACA) lays the groundwork for a substantial increase in the number of people who will have access to health insurance through either Medicaid expansion or the Health Insurance Marketplace. States are now tasked with reaching out to and enrolling newly eligible persons. State and local public health departments are often trusted entities in the community and can leverage resources and data to facilitate outreach and enrollment. In 2014, RAND and NACCHO conducted an environmental scan, key informant interviews, and site visits in order to explore innovative models and best practices for local health departments engaged in outreach and enrollment. This series of case studies and publications describes seven innovative models with a focus on the unique role of local health departments and their leadership.  

  • Boston, MA
  • Eagle County, CO
  • Houston, TX
  • Illinois 
  • New Orleans, LA
  • Tacoma County, WA
  • West Virginia  
  • Publications 

Webinar: Assessing the Role of Public Health in ACA Outreach and Enrollment

Description: During this 60-minute webinar, presenters will share barriers and facilitators and offer compelling models to guide local health department engagement in outreach and enrollment.

Collaboration Between Health Care and Public Health: Workshop Summary (2015)

"On February 5, 2015, the Institute of Medicine Roundtable on Population Health Improvement hosted a workshop to explore the relationship between public health and health care, including opportunities, challenges, and practical lessons. The workshop was convened in partnership with the Association of State and Territorial Health Officials (ASTHO)-Supported Primary Care and Public Health Collaborative. Organized in response to the 2012 IOM report Primary Care and Public Health: Exploring Integration to Improve Population Health, this workshop focused on current issues at the interface of public health and health care, including opportunities presented by and lessons learned from the Centers for Medicaid and Medicare Services State Innovation Models program. The workshop featured presentations on several dimensions of the public health-health care relationship. Collaboration Between Health Care and Public Health summarizes the presentations and discussion of the event. You can order the workshop summary here."

How Modeling Can Inform Strategies to Improve Population Health: Workshop Summary

The Roundtable on Population Health Improvement held a public workshop on April 9, 2015, which featured a number of presentations and discussions exploring how modeling can inform strategies to improve population health. "A growing interest in systems science approaches to population health has led public health researchers, regulators and others to turn to modeling more than ever, and many types of models have been used to forecast health effects associated with current and future risk behaviors." You can read the workshop summary here.