It has been suggested that as much as 50% of population health outcomes can be attributed to social determinants of health (SDOH), the conditions in which people live (O’Hara, 2005). Despite widespread recognition of the importance of SDOH, little has been done to support primary care in effectively responding to the social aspects of patients’ health (Bloch, Broden, & Rozmovits, 2011). Using a variety of design research methods, this study investigated why rural family physicians are not successfully addressing SDOH of low-income patients. This exploration revealed underlying cultural and systemic barriers that inhibit physicians from meeting the social needs of their patients. From this understanding, the Community Health Accelerator (CHA) concept was developed. The CHA is a system innovation that bridges primary care and the community to create significant population health improvements and long-term reductions in health care expenditures.