ACHs are an integral part of the Washington’s Medicaid transformation efforts. There are nine ACHs covering the state, each serving a distinct region. Each ACH is unique but they share a common approach to improving the health of their communities and transformation health care delivery. We are all tackling complicated problems through cross-sector collaborations and investments in innovative approaches. Over the past six years, ACHs have led efforts to transform our local health care systems connecting health care, social determinants of heath and equity efforts to support health across sectors, and investing millions of dollars with providers and community partners.