Research shows that chronic conditions such as diabetes, hypertension, and heart disease are more prevalent among rural residents than their urban counterparts, a situation exacerbated by with behavioral health disparities (obesity, drug & alcohol abuse) and issues with accessing health care. This project addressed the role and performance of CAHs in undertaking community and population health improvement activities targeted to these chronic conditions. The project created a framework for monitoring and supporting CAHs and their state partners in adopting and implementing evidence-based interventions and performance measures focused on prevalent chronic health and access issues in rural communities. This culminated in a policy brief targeted to State Flex Coordinators and CAHs that synthesized the evidence base and provided best-practice examples of relevant initiatives involving CAHs, other rural hospitals, public health organizations, and community organizations to address prevalent chronic illness, behavioral health, and access issues.