Growing evidence suggests that in order to improve a population’s health in a significant and sustained way there must be clear direction, commitment, and effective collaboration between the many entities that provide care or engage in community improvement. Effective collaborations can make positive strides in addressing the social determinants of health, which affect population health. Hospitals play a significant role in care delivery, from basic attention to the most sophisticated interventions, but certainly, all organizations want to provide the highest quality services to the populations they serve. State health departments can play an important role in driving what hospitals are doing, convening this collaboration, and facilitating success at the local level. This perspective discusses challenges and barriers that state and local partners face related to collaborating on the above needs assessments, as well as examples of successful state strategies that can overcome these barriers.