CHRT Project: Safety Net

Enhancing Organizational and Operational Efficiencies in Michigan's Safety Net Providers

Population Health and Access to Care

The purpose of the study is to examine how Michigan’s health care safety net organizations (SNOs), primarily Federally Qualified Health Centers (FQHCs) and community-based organizations such as free clinics, can enhance their organizational and operational efficiencies to make maximum use of available resources.

Goals

The study’s specific objectives are to:

• Identify initiatives that SNOs can implement to enhance and sustain efficiency
• Recommend appropriate primary care models for SNOs
• Provide tools and recommendations to SNOs to optimize resources and expand service delivery

Another project goal is to bridge the gap between academic research and the issues clinic directors face. The investigators plan to recommend concrete strategies clinics can use to enhance their efficiencies.

Background

Previous research by Professor Jacobson on the safety net in Michigan (funded by the BCBSM Foundation) revealed that unmet need is expanding faster than organizational capacity and that SNOs are unable to keep up with that demand. A recent report by CHRT confirms that the entire safety net is under stress, with rising numbers of uninsured and steep increases in the cost of hospital uncompensated care.

Approach

Investigators will conduct a series of case studies of various SNOs within ten Michigan communities. Through interviews with clinic leaders and staff, the project will examine how the clinics define and measure efficiency, the internal and external factors affecting efficient organizational and operational strategies, and best practices that can be shared with other clinics.

To prepare for these case studies, investigators will conduct a literature review aimed at identifying strategies and validated efficiency measures used by small businesses and clinics to operate more efficiently. The literature review will also examine primary care delivery models that might be applicable to SNOs.

Related Research and Information

Survival Strategies for Michigan's Health Care Safety Net Providers
HSR. 2005; 40(3):923–940.

Free Clinics Helping to Patch the Safety Net
J Health Care Poor Underserved. 2004 Feb;15(1):42-51.

Help for Michigan's Health Care Safety Net
Press Release PDF (72 Kb file) | Word (282 Kb file)

Investigators

Peter D. Jacobson, JD, MPH
Professor of Health Law and Policy, Department of Health Management and Policy, University of Michigan School of Public Health
Director, Center for Law, Ethics, and Health

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