摘要:

The history of community health centers (CHCs) reflects attitudes toward health care delivery in general. Developed as part of the war on poverty, they later survived the more conservative attitudes of the early 1970s to flourish In the late 1970s. In the 1980s, we again witnessed a reduction In the funding available to CHCs. In response to this, The Robert Wood Johnson Foundation (RWJF) established The Program to Strengthen Primary Care Health Centers. The program was designed to help centers to adapt to this environment by becoming more businesslike In their operations and decreasing their dependence on public dollars.

ISSN:0148-9917    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This article provides insights into the history of community health centers (CHCs) and the role that they play in providing care to the poor. The mission of the CHC has always been to provide comprehensive primary care services to community residents regardless of their ability to pay. Health centers served an estimated 7 million people in 1993. In the near future, centers will be faced with new challenges. For example, the nationwide momentum toward managed care Is defining new areas of growth for health centers, including new forms of practice management and contractual arrangements with other providers.

ISSN:0148-9917    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The Program to Strengthen Primary Care Health Centers supported improvements in operating systems and the development of good business practices at participant centers. This article provides an overview of the Program. Participant centers were small, community-based organizations that served high-need populations and offered a sliding fee scale for uninsured patients. Grants supported activities to increase patient revenues, serve more patients, promote general stability of center operations, expand the kinds of services provided, and enhance nonpatient revenues. Successful organizations needed to take a step back and analyze their options and also to have a good management team.

ISSN:0148-9917    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The primary goal of The Program to Strengthen Primary Care Health Centers was to identify innovations that could Improve the financial viability of health centers. This article describes the impact of program-related innovations on financial indicators. During the study period, all of the participant centers continued in existence, whereas one of the comparison centers went bankrupt. Total revenue and net income both Improved significantly for the study centers relative to the comparison group. Centers that received audits of their operational systems prior to program commencement fared less well than those that did not.

ISSN:0148-9917    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This article describes the implementation of Innovations at health centers participating in The Robert Wood Johnson Foundation Program to Strengthen Primary Care Health Centers. Relatively successful approaches to management innovation are described and common obstacles to innovation are considered. Key issues include poor physician retention, inadequate or inappropriate space, the complexities of automation, difficulty In the recruitment of staff and consultants (particularly in rural areas), and disruptions caused by internal promotions.

ISSN:0148-9917    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Long-term financial viability was a goal of The Program to Strengthen Primary Care Health Centers. To accomplish this, it was expected that participant centers would increase their management capabilities, We evaluated 32 management techniques In five principal areas: budgeting, strategic planning, general financial management, collections, and general health services management. Eight of the techniques showed change over the course of the demonstration (six increases and two decreases). It appears that there was somewhat more improvement among study centers than In a comparison group. Management sophistication has been expanding among health centers In general; Program participation appears to have accelerated this growth.

ISSN:0148-9917    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This article discusses the experiences of four individual health centers that participated In The Program to Strengthen Primary Care Health Centers. These centers were attempting “typical” initiatives, were considered highly likely to succeed, and were located In geographically diverse areas. Given these characteristics, it is likely that other centers could replicate their endeavors and could gain valuable knowledge from their Implementation experiences. This article presents each center's characteristics, history, and mission; describes the environment In which the center operates; and discusses the barriers to implementation of selected innovations.

ISSN:0148-9917    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This article presents an account of one center's experience participating in The Program to Strengthen Primary Care Health Centers. The center developed a multlfaceted strategy that aimed to Increase and diversify revenue, both earned and nonearned. The first year got off to an uneven start, although the project eventually progressed according to plan but on a slower time line than anticipated. By the end of the three-year project period, most of the Initiatives had become fully integrated into center operations. The center was able to increase financial reserves. However, their financial stability remained tenuous.

ISSN:0148-9917    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This article highlights results from the evaluation of The Program to Strengthen Primary Care Health Centers, and suggests some directions for public policy. Program participants reported substantial improvements In financial viability, given the relatively small monetary investment. Technical assistance In the development of Innovations, however, appears to dampen creativity and ultimately hinder financial gains. Recommendations address improved physician retention, the development of professional expertise, the Importance of attention to long-range objectives, the related problems of excess capacity and surplus patient demand, and the integration of primary care health centers into managed care systems and health networks.

ISSN:0148-9917    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Given the modest amount of resources provided by the Foundation through The Program to Strengthen Primary Care Health Centers, the grantees undertook a high level of activity. Perhaps centers were aided by the momentum and focus of the Program in addition to financial resources. Such grants seem to move longer-range projects onto the daily agendas of managers. It might be worthwhile to convert some portion of federal community health center funding to support financial and managerial Innovations, Generally, positive evaluation findings should encourage centers to explore some of the demonstrated initiatives. Evolution and innovation are considered key to the survival of primary care health centers.

ISSN:0148-9917    

出版商:OVID    

年代:1995

数据来源: OVID