Using the balanced scorecard to characterize benefits of integration in the safety net

The purpose of this study was to develop a comprehensive framework depicting the potential benefits of integration among health-care providers that serve vulnerable populations. Research teams interviewed participants in 12 integrated functions across seven community health-centre-led networks. Functions included clinical processes; managed care contracting; and administrative services such as human resources, finance, and information systems. Using a Balanced Scorecard framework, benefits were identified across financial, customer, internal business, and learning and growth perspectives. Financial benefits were more frequently cited relative to managed care and administrative functions than relative to clinical functions. Clinical functions were frequently characterized by perceived improvements in patient care quality, while managed-care functions appeared to yield most benefits in access. Administrative functions were most often associated with improvements in internal business operations. There were substantial findings in learning and growth across all three types of integration, in keeping with the early stages of the integrated functions in the study. Findings imply that integration among health-care providers yields a wide range of benefits, but not necessarily quickly or financial in nature.