While there has been an enormous amount of attention paid to the transformation of the United States Health Care delivery system under the Affordable Care Act, little has been said about the many opportunities in the ACA for population health systems improvement that will present as the result of moving to an environment where a substantial portion of the population has a health insurance card.

The governmental public health system has three core functions as defined in a 1988 report by the Institute of Medicine. These functions are to assess the health of the community, lead and promote evidenced-based policies that are in the public’s interest, and assure the availability of community and personal health services that are viewed by their constituents as appropriate and necessary. These public health functions will not change with health reform, but many of their component activities will as the health system is transformed.

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