Health Care Management Science

, Volume 17, Issue 4, pp 348–364 | Cite as

Balancing investments in federally qualified health centers and Medicaid for improved access and coverage in Pennsylvania

  • Paul M. Griffin
  • Hyunji Lee
  • Christina Scherrer
  • Julie L. Swann


Two common health disparities in the US include a lack of access to care and a lack of insurance coverage. To help address these disparities, healthcare reform will provide $11B to expand Federally Qualified Health Centers (FQHCs) over the next 5 years. In 2014, Medicaid rules will be modified so that more people will become eligible. There are, however, important tradeoffs in the investment in these two programs. We find a balanced investment between FQHC expansion and relaxing Medicaid eligibility to improve both access (by increasing the number of FQHCs) and coverage (by FQHC and Medicaid expansion) for the state of Pennsylvania. The comparison is achieved by integrating multi-objective mathematical models with several public data sets that allow for specific estimations of healthcare need. Demand is estimated based on current access and coverage status in order to target groups to be considered preferentially. Results show that for Pennsylvania, FQHCs are more cost effective than Medicaid if we invest all of the resources in just one policy. However, we find a better investment point balancing those two policies. This point is approximately where the additional expenses incurred from relaxing Medicaid eligibility equals the investment in FQHC expansion.


Medicaid Federally qualified health centers Multi-criteria optimization Utility 

Supplementary material

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Paul M. Griffin
    • 1
  • Hyunji Lee
    • 1
  • Christina Scherrer
    • 2
  • Julie L. Swann
    • 3
  1. 1.Department of Industrial and Manufacturing EngineeringPenn State UniversityUniversity ParkUSA
  2. 2.Department of Industrial Engineering TechnologySouthern Polytechnic State UniversityMariettaUSA
  3. 3.School of Industrial and Systems EngineeringGeorgia Institute of TechnologyAtlantaUSA

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