Like a tree falling in the forest, health care innovations don't make a sound — until they are successfully replicated in the world. Four big providers are experimenting with how this works.

Case studies describe the experiences and insights of safety-net provider organizations that have used management and process reengineering methods to provide more comprehensive and cost-efficient care.

This paper describes efforts to improve efficiency in safety-net hospitals through management engineering, a method for diagnosing and correcting problems in service delivery. A companion primer outlines specific methods that have proven successful.

Safety-net clinics improved productivity and patient satisfaction by implementing process and structural changes, including confirming patient appointments and organizing visits around the patient.

This paper focuses on whether a public hospital's governance structure helps or hinders its ability to respond competitively to changes in the health care environment.

This Health Affairs article by Pham et al. examines how an integrated delivery system responded to threatened exclusion from an insurer's network by attempting to reduce costs though redesign of its care delivery model.