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Integrating health care for the most vulnerable: Bridging the differences in organizational cultures between US hospitals and community health centers

Author

Listed:
  • Ko, M.
  • Murphy, J.
  • Bindman, A.B.

Abstract

Policymakers have increasingly promoted health services integration to improvequality andefficiency. The US health care safety net, which comprises providers of health care to uninsured,Medicaid,andother vulnerable patients, remains a largely fragmented collection of providers. We interviewed leadership from safety net hospitals and community health centers in 5 US cities (Boston, MA; Denver, CO; Los Angeles, CA; Minneapolis, MN; and San Francisco, CA) throughout 2013 on their experiences with service integration. We identify conflicts in organizational mission, identity, and consumer orientation that have fostered reluctance to enter into collaborative arrangements. We describe how smaller scale initiatives, such as capitated model for targeted populations, health information exchange, and quality improvements led by health plans, can help bridge cultural differences to lay the groundwork for developing integrated care programs.

Suggested Citation

  • Ko, M. & Murphy, J. & Bindman, A.B., 2015. "Integrating health care for the most vulnerable: Bridging the differences in organizational cultures between US hospitals and community health centers," American Journal of Public Health, American Public Health Association, vol. 105, pages 676-679.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2015.302931_1
    DOI: 10.2105/AJPH.2015.302931
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