PMID- 35019863
OWN - NLM
STAT- MEDLINE
DCOM- 20220418
LR  - 20220418
IS  - 1550-5030 (Electronic)
IS  - 0361-6274 (Linking)
VI  - 47
IP  - 2
DP  - 2022 Apr-Jun 01
TI  - Antecedents of geographical expansion: The case of federally qualified health 
      centers.
PG  - E32-E40
LID - 10.1097/HMR.0000000000000327 [doi]
AB  - BACKGROUND: Federally qualified health centers (FQHCs) are pivotal safety net 
      primary care providers for the medically underserved. FQHCs have complex 
      organizational designs, with many FQHCs providing care at multiple physical 
      locations ("sites"). The number of sites, however, varies considerably between 
      FQHCs, which can have important implications for differential access that may 
      perpetuate disparities in quality of care. PURPOSE: The objective of this study 
      is to explore the organizational and environmental antecedents of the number of 
      sites operated by each FQHC. The findings of this study contribute to a better 
      understanding of FQHCs' expansion that has vital implications for cost and access 
      outcomes. METHODOLOGY/APPROACH: The study is based on data between the years 2012 
      and 2018. Using multivariate growth curve modeling, we analyzed the final sample, 
      consisting of 5,482 FQHC-years. RESULTS: The level of competition, measured as 
      the number of FQHC sites in the Primary Care Service Area (PCSA) and the number 
      of primary care physicians per 1,000 PCSA residents, was positively associated 
      with the number of FQHC sites. The number of patients, the level of federal 
      grant, and the year were also positively associated with the number of FQHC 
      sites, whereas percentage of Medicaid patients; workforce supply, measured as 
      primary care physician assistants per 1,000 PCSA residents; Medicaid expansion; 
      and state/local funding available for FQHCs were not. CONCLUSION: Findings of 
      this study indicate that competition, especially between peer FQHCs, is 
      significantly associated with FQHC expansion. PRACTICE IMPLICATIONS: This result 
      suggests that FQHC managers and policymakers may closely monitor cost, access, 
      and quality implications of competition and FQHC expansion.
CI  - Copyright (c) 2022 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Choi, Seongwon
AU  - Choi S
FAU - Weech-Maldonado, Robert
AU  - Weech-Maldonado R
FAU - Powers, Thomas L
AU  - Powers TL
FAU - Hearld, Larry R
AU  - Hearld LR
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Health Care Manage Rev
JT  - Health care management review
JID - 7611530
SB  - IM
MH  - *Health Services Accessibility
MH  - Humans
MH  - Medicaid
MH  - *Safety-net Providers
MH  - United States
EDAT- 2022/01/13 06:00
MHDA- 2022/04/19 06:00
CRDT- 2022/01/12 12:27
PHST- 2022/01/13 06:00 [pubmed]
PHST- 2022/04/19 06:00 [medline]
PHST- 2022/01/12 12:27 [entrez]
AID - 00004010-900000000-99600 [pii]
AID - 10.1097/HMR.0000000000000327 [doi]
PST - ppublish
SO  - Health Care Manage Rev. 2022 Apr-Jun 01;47(2):E32-E40. doi: 
      10.1097/HMR.0000000000000327.