Transforming a Family Medicine Center and Residency Program Into a Federally Qualified Health Center

Abstract

The authors describe a family medicine center before and after a merger between the Keck School of Medicine of the University of Southern California, the California Hospital Medical Center, and the Eisner Pediatric and Family Medical Center in 2012. The merger provided new opportunities to stabilize the financial base of a clinical practice struggling financially and to enhance the training of residents and other health professionals in primary care, which motivated the partners to consider this new model. After 18 months of negotiations, they were able to convert the family medicine center and residency program into a new federally qualified health center. The benefits to this new model include an increase in both patient volume and the quality of education, supporting residency accreditation; a greater number of residents from U.S. medical schools; enhanced education and preparation of primary care physicians for practice in medically underserved communities; enhanced reimbursements and new opportunities for state, local, and federal grants; and quality improvement and new information technology. The partners overcame academic, administrative, legal, and regulatory obstacles, communication barriers, and differences in culture and expectations to achieve this merger. Keys to their success include the commitment of the leaders at the three institutions to the goals of the merger, a dedicated project manager and consultants, opportunities for new revenue sources and reimbursements, and support from a pioneering charitable foundation. The authors conclude by discussing the implications of using community health centers as the focal point for training primary care clinicians and addressing workforce shortages.

Incorporating an Increase in Plant-Based Food Choices into a Model of Culturally Responsive Care for Hispanic/Latino Children and Adults Who Are Overweight/Obese

“…In 2010, the Department of Family Medicine and Diabetes Education of Adventist Health White Memorial (AH-WMMC) Medical Center adapted and implemented HELP to be a culturally tailored plant-based diet and physical activity intervention for pediatric obesity in Hispanic/Latino families. At AH-WMMC, HELP was delivered through a highly successful model of culturally responsive care that was developed, implemented, and disseminated by AH-WMMC in 2008 [ 21 , 22 ]. We will describe the HELP Program, the qualitative evaluation methods of HELP, and its quantitative evaluation methods.…”

“…For the present study, Loma Linda University partnered with Adventist Health-White Memorial Medical Center (AH-WMMC)—a health care organization operating in a medically underserved, East Los Angeles catchment area that is 90% Hispanic-Latino (85% Mexican). AH-WMMC has developed a successful model of culturally responsive care for their patient population [ 21 , 22 ], and this care model has been recently used to adapt and pilot test culturally tailored plant-based diet and physical activity interventions for Hispanic/Latino Patients. Specifically, the AH-WMMC Diabetes Education Office adapted a hospital-based, family centered intervention—the Healthy Eating Lifestyle Program (HELP) [ 23 , 24 ]—for use as a plant-based diet intervention for Hispanic/Latino pediatric patients with obesity and their families.…”

Evaluating the potential merger of two internal medicine residency programs: process and recommendations

“…• How did you sell the idea of the merger to multiple departments? [3][4][5][6][7][8][9][10][11][12]. The combination of the interviews with DIOs and the literature review led to a working lessons learned document.…”

“…The merger rate doubled within two years of the passage of the ACA compared to pre-ACA values [1,2]. There are little data on the effects these post-1990 mergers had on GME programs, including a complete absence of case studies in the merger of internal medicine residency programs [3][4][5][6][7][8][9][10][11][12]. Although the decision to merge institutions will be made at a level generally much higher than that of a department chair or program director in internal medicine (IM), it will be up to department chairs and program directors to operationalize the mergeror argue for continued independence.…”

Two Novel Urban Health Primary Care Residency Tracks That Focus On Community-Level Structural Vulnerabilities

“…7,8 Educational efforts aimed at addressing the health needs of urban communities have focused on engaging medical students in community health projects and the social determinants of health. [9][10][11][12] At the graduate medical education level, training programs have expanded resident exposure to primary care, 13,14 fostered interactions with vulnerable populations, 15,16 and offered didactic programs on the social determinants of health and political advocacy. [17][18][19] To confront structural vulnerabilities and build upon the strengths of East Baltimore communities, we created two urban health residency (UHR) programs at Johns Hopkins Hospital (JHH).…”