As the Affordable Care Act pushes doctors and hospitals to join forces to slash health care costs, those with the least-expensive solutions say they're still largely being ignored. Community health groups and companies that specialize in healthy eating and fitness are arguing for more recognition of non-medical ways to prevent and treat chronic conditions such as diabetes, hypertension and heart disease. Physicians and hospitals are rapidly forming what's known as accountable care organizations (ACOs) to reduce the duplication of services and keep large groups of patients well. But community groups, which could be far less expensive partners, have to fight for a "seat at the table" on the doctor-dominated boards of ACOs, according to a 2014 report by a North Carolina physicians' coalition.