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

Michelle J Ko, Julia Murphy, Andrew B. Bindman

Research output: Contribution to journalArticle

4 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)S676-S679
JournalAmerican Journal of Public Health
StatePublished - Nov 1 2015
Externally publishedYes


ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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