October 1 is the first anniversary of the debut of the federal and state health care exchanges that allow Americans to assess insurance options and purchase coverage under the Affordable Care Act. Since then 7.3 million people have signed up, and another 4.8 million have obtained access to health care through the expansion of Medicaid.

While falling well short of early projections, the ACA has gone a long way toward achieving one of its primary objectives — significantly reducing the number of the uninsured.

The jury is still out on the legislation’s other major goal, reining in the seemingly ceaseless rise in health care expenditures, but there is no doubt that the ACA has helped stimulate a rigorous reconsideration of health care delivery models. Much of that work is occurring in the private sector, which, together with employees, is responsible for almost half of the nation’s $2.8 trillion-a-year health care bill.

A new report issued by the CEO Council on Health and Innovation, together with the Bipartisan Policy Center, reflects the seriousness with which business leaders take the issue. The council — whose members include Greg Wasson of Walgreens as well as the heads of Johnson & Johnson, McKinsey & Co., Aetna, Coca-Cola, Ver­izon, Bank of America, Blue Cross Blue Shield Association, and Institute for Advanced Health and NantHealth — is intent on serving as a catalyst for improvement.

The challenge is urgent and immense, affecting not only the well-being of Americans but the ability of U.S. businesses to compete effectively in the global economy. As the report notes, despite spending much more per capita than any other country, the U.S. ranks near the bottom or dead last in a comparison of health care in 11 countries in terms of access, efficiency, equity and the health of citizens. There is much work to do, and leaders in the private sector appear to be ready to take it on.

“America’s business community has always been an effective driver of change and progress,” the report states. “We are strongly committed to taking action to improve the health and wellness of the nation as a whole, and to promote higher-quality, cost-effective, patient-centered care.”

The CEO Council and Bipartisan Policy Center offer a wealth of ideas about what employers might do to bring about improvement in three areas — the health and wellness of individuals, the health of communities and the performance of the health care system. The recommendations, which are presented as a starting point for what inevitably will be a long-term project, are based on the experience of individual companies.

Walgreens is one of them. It will come as no surprise to anyone who follows the retail pharmacy business that the company is an active participant in the effort to improve the health of the communities it serves.

The report cites ongoing work in such areas as raising immunization rates, broadening access to care through in-store clinics and using technology to enhance coordination of care. Less widely known are the initiatives Walgreens has taken to better the health of employees. They include lowering barriers to preventive care by providing free vaccinations and biometric screening and offering disease management and wellness coaching services to individuals with chronic conditions.

The report examines related programs at six other companies — Aetna, Bank of America, Blue Cross Blue Shield, McKinsey, Coca-Cola and Verizon — outlining the benefits and impact of those efforts for each of them, lessons learned and key take-aways for other employers. Not every program is applicable to every company, but all of the initiatives provide food for thought.

The CEO Council is not the only group of prominent executives to make health care a priority. The Business Roundtable, another group of chief executive officers from major corporations, issued its recommendations for fixing the nation’s health care system earlier this month [September]. “Driving Innovation in the Health Care Marketplace” calls for greater transparency around performance, stronger incentives for providers and consumers to improve value, and the alignment of public and private efforts.

“There are many ways that Americans can get and stay healthier,” says Larry Merlo, CEO of CVS Health and vice chairman of the roundtable’s health and retirement committee. “There are a number of innovations we can take advantage of to deliver greater value and better quality. We’re doing it now at our companies, and our experience can provide a blueprint for others.”

It is good to see America’s business leaders tackle health care. The private sector, together with government, created the flawed system that we have today. Both will have to step up and contribute if health care delivery is to become more efficient and effective.