Table 3.

Three Board Decision-Making Philosophies in Community Health Centers

Mission Dominant	Margin Dominant	Balanced Approach
“There’s a lot of cancer in this particular area. We have been successful in getting a new digital mammography machine, and so we’ve been doing outreach and letting people know that we are going to do mammograms for a minimal fee. They were $25, which is a loss, but it’s worth it to get these patients in to take it. The very first one we did had cancer, so we felt like that was worthwhile….Flu shots are another thing. This year we had to take a loss in flu shots, but its better in the long run to do these things as a service to the public.” “I don’t believe anything has ever been sent to collections, ever. That’s not who we are.”	“I don’t think we have ever approved anything knowing it was going to lose money to start with. I don’t recall any incidents like that, that we would ever approve anything that was going to put us in the red from the beginning.” “We typically bill patients. Some of the bills are sent to collections every month. We review the total amount of bills every month that need to be sent to collections.”	“Oh yeah, I mean we aren’t in the business to make money so-to-speak, we’re in the business to provide the best patient care that we can, but we have to remain financially stable or we would be unable to accomplish our mission. We don’t look to make money on each and every segment of the services that we provide.”