Success Under Duress: How Five Hospitals Thrive Despite Challenging Payer Mix

Despite their challenging payer mix, a number of California's safety-net hospitals have achieved robust financial success. To find out how, researchers conducted in-depth interviews with the leadership teams at five such institutions.

September 2010

For years, many of California's safety-net hospitals, a major source of care for the state's low-income, uninsured, and underinsured populations, have struggled financially.

Despite the economic challenges of serving these populations, some safety-net hospitals are achieving financial success. Research conducted for this report examined five such facilities of different sizes, local market factors, and system affiliations.

Interviews with leaders of these hospitals — Alameda County Medical Center in Oakland, Fairchild Medical Center in Yreka, Marian Medical Center in Santa Maria, Providence Holy Cross Medical Center in Mission Hills, and Sierra View District Hospital in Porterville — revealed strong similarities in their business approaches and operational practices.

The leaders credited their financial success to strategies that included:

  • Heavy investment in quality improvement initiatives
  • Sustained growth in patient service volume
  • Frequent and intense monitoring of expenditures and efficiency

Those interviewed explained that these approaches were supported by their hospitals' culture — which included such attributes as promoting talent from within and a firm commitment to service — and were enabled by strong hospital-physician relationships.

The issue brief is available under Document Downloads. The full report is available on the BioMedSearch site listed under External Links.