Giving Compass' Take:

• The Commonwealth Fund discusses local health care markets and how communities improved (or didn't), finding that localized efforts such as reforming delivering systems worked.

• What can we learn from this "scorecard" in a broader sense? More access to health interventions for marginalized people are a must, as is building up non-medical programs such as affordable housing.

• Here's more on human services’ critical role in improving health care.

Some U.S. communities perform consistently well on The Commonwealth Fund’s Scorecard on Local Health System Performance. Hoping to learn what drives health system change, we decided to look at a different set of standouts on the most recent scorecard: the most improved.

We found that just a handful of regional health care markets — 14 of 306 — advanced on a majority of the 2016 local scorecard’s 33 trending indicators of health care access, quality, cost, and outcomes. Half were communities that had poverty rates above the national average, demonstrating that the capacity to improve is not limited to those areas with ample resources.

In Akron, the health department and city and county governments have found opportunities for collective action, most recently for raising awareness of symptoms of mental illness and reducing health disparities. Such collaboration, which is threaded into the fabric of this “big small town,” was promoted by a former county official who encouraged the health, housing, transit, aging, and social service agencies to pool their efforts to improve residents’ quality of life. In one instance, the county combined funds from multiple agencies to purchase baby cribs for low-income families; since that time, there have been very few infant deaths from cosleeping ...

In the communities we studied, collaboration across sectors — not just within health care — appears to be central to advancing local health system performance in both large and small ways.

Understanding what fosters effective collaboration is more elusive, though it appears to be aided by civic pride and by social capital, defined as “networks together with shared norms, values, and understandings that facilitate co-operation within or among groups.”

Read the full article about improving healthcare systems locally by Sarah Klein, Martha Hostetter and Douglas McCarthy at The Commonwealth Fund.