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com/55. 123articleonline. com/56. articleavenue. com/57. simplysearch4it. The public health and clinical care environment is evolving partially in response medical doctor Patient Protection and Affordable Care Act ACA. Section 501r3 of doctor Patient Protection and Affordable Care Act ACA requires that nonprofit hospitals conduct and report on a neighborhood health needs evaluation CHNA every 3 years medical maintain their tax exempt status 3. The ACA also requires that a CHNA bear in mind input from stakeholders that characterize doctor broad interests of doctor community served by doctor hospital, including those with particular information or expertise in public health, equivalent to LHDs. New methods of care with PCPs intended medical improve affected person results and reduce costs have also been developed in recent years. These include State Innovation Models state based, multipayer health care charge and repair birth models, patient centered medical homes fundamental care delivery models which are affected person centered, complete, team based, available, and focused on excellent and safety, and accountable care agencies networks of health care suppliers voluntarily guilty for offering coordinated care medical patients 4. An online survey was distributed during JanuaryFebruary 2015 medical a statistically representative sample of 948 LHDs across all regions of doctor United States, representing about one third of all LHDs.