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Case Study

Understanding the Health Care Ecosystem for Low-Income Consumers


Mid-Atlantic Association of Community Health Centers




Organizational Development


What does the environment look like for low-income consumers of health care and how can we prepare our members to better serve them?

The executive director of the Mid-Atlantic Association of Community Health Centers (MACHC) hired us to help them examine these questions on behalf of their members, Federally Qualified Community Health Centers (FQCHCs or FQHCs).


We decided to use one of our signature strategic planning tools, ecosystem mapping, to drive the engagement.

Over several months, we completed 17 one-hour telephone interviews with a variety of stakeholders in the health care field throughout the Mid-Atlantic region. Most of the interviewees were leaders of FQHCs, but not all. Some were representatives from state health departments, and others were representatives from various trade associations and interest groups representing doctors, hospitals, and FQHCs themselves. When combined, the interviews painted a dynamic portrait of a rapidly changing ecosystem for FQHCs and consumers.

At the conclusion of the engagement, we worked with a graphic designer to transfer the insights from our research into a visual diagram of the ecosystem for low-income consumers of health care. We presented that diagram during a retreat of MACHC board members that we facilitated. We left MACHC with a comprehensive written report of the key findings from our research, as well as with a list of the recommended action steps they and their members could take to provide better services for low-income consumers.


Through our work with this client, we demonstrated a number of our core business capabilities. The research and consulting engagement included: (1) data collection and data analysis; (2) in-depth interviews with staff; (3) facilitated planning sessions with senior staff; (4) financial analysis of the organization’s financial condition; (5) tools to assist the senior leaders with budgeting and financial planning; (6) an organizational assessment in key functional and program areas; (7) a comprehensive SWOT and PESTEL analysis; (8) and a written strategic plan (9) with communications recommendations on how it should be presented and framed to the board, staff, customers, and other stakeholders.