From 2018-2020, NIRH and the Hawaii Maternal & Infant Health Collaborative (HMIHC) worked on statewide systems change to ensure access to LARC in the inpatient hospital setting. HMIHC developed buy-and-bill programs in two hospitals in an effort to create sustainable models for immediate postpartum LARC access. This effort will especially benefit people in rural communities, patients with private insurance, and those who have limited access to care due to immigration or income status. HMIHC also advocated for private insurers to match the state’s Medicaid policy, which reimburses hospitals for immediate postpartum LARC device placement, and worked in hospitals across the state to build stakeholder support and cultivate provider-champions who will lead implementation within their health systems.