Organization

The Stephen M. Shortell Center for Organizational Research in the Health Sector Publications

Why HR Has Failed to Address Healthcare's WorkforceCrisis: The Need for a Systems Partner Role

February 11, 2026

A new paper co-authored by CHAMP visiting faculty Aoife McDermott and CHAMP faculty Hector Rodriguez argues that human resources functions in healthcare have fallen short in addressing the sector's deepening workforce crisis — and offers a concrete framework for how HR can expand its role to drive meaningful, system-level change.

The study, "Why HR Has Failed to Address Healthcare's Workforce Crisis: The Need for a Systems Partner Role," was published this month in the Human Resource Management Journal. The paper was co-authored by Aoife M. McDermott, a 2022–23 Commonwealth...

Why HR Has Failed to Address Healthcare's Workforce Crisis: The Need for a Systems Partner Role

Aoife McDermott
Graeme Currie
Hector P Rodriguez
2026

Attempts to remedy sustained workforce challenges facing healthcare organizations globally have been largely ineffective,despite increased political attention. In this paper we draw on contextually based human resource theory to explain why thesechallenges remain intractable. We demonstrate that professional healthcare workers' employment relationships are embeddedwithin systems as well as organizations, and that system‐level constraints limit organizational capacity to address workforceissues. Informed by UK and US examples of issue‐oriented, place‐based and system approaches to...

2025 California Primary Care Language Access Survey Report

March 9, 2026
Executive Summary The 2025 California Primary Care Language Access Survey (CPCLAS), sponsored by the California Health Care Foundation (CHCF), is the first statewide assessment of language access infrastructure within California’s safety-net clinics, addressing a critical data gap as federal protections for Limited English Proficiency (LEP) populations face potential rollback. Leveraging survey data from 101 clinic leaders and 14 in-depth qualitative interviews, the report illuminates the operational realities of Community Health Centers (CHCs) and independent primary care practices serving...

2025 California Primary Care Language Access Survey Report

Executive Summary The 2025 California Primary Care Language Access Survey (CPCLAS), sponsored by the California Health Care Foundation (CHCF), is the first statewide assessment of language access infrastructure within California’s safety-net clinics, addressing a critical data gap as federal protections for Limited English Proficiency (LEP) populations face potential rollback. Leveraging survey data from 101 clinic leaders and 14 in-depth qualitative interviews, the report illuminates the operational realities of Community Health Centers (CHCs) and independent primary care practices serving...

California Medical Interpreter Pilot Project (MIPP) Evaluation

February 25, 2026
Executive Summary

Language access remains a significant barrier for millions of Medi-Cal members in California, hindering their ability to fully understand medical information, provide informed consent, and engage effectively in their own care. This often leads to misdiagnosis, treatment errors, reduced adherence to medical advice, and persistent health disparities. Existing solutions have often been fragmented or insufficient, underscoring the critical need for a comprehensive and standardized approach to language services.

To address these challenges, the California Department of...

Medical Interpreter Pilot Project (MIPP) Evaluation

Executive Summary

Language access remains a significant barrier for millions of Medi-Cal members in California, hindering their ability to fully understand medical information, provide informed consent, and engage effectively in their own care. This often leads to misdiagnosis, treatment errors, reduced adherence to medical advice, and persistent health disparities. Existing solutions have often been fragmented or insufficient, underscoring the critical need for a comprehensive and standardized approach to language services.

To address these challenges, the...

U.S. Primary Care Practice Capabilities Linked to Language Services for Patients with Limited English Proficiency

Stacy Chen
Jenny Guadamuz
Hector P Rodriguez
Karen E Schifferdecker
2025
Background

Patients with limited English proficiency (LEP) experience more challenges with clinician communication than English-proficient patients. U.S. federal policies require the provision of language services, but little is known about language service availability in adult primary care practices nationally.

Objective

To identify primary care physician practice capabilities associated with the routine availability of language services for patients with LEP.

Design

Nationally representative physician practice survey data from the National Survey of Healthcare...

U.S. Primary Care Practice Capabilities Linked to Language Services for Patients with Limited English Proficiency

December 1, 2025

A new study led by CHAMP trainee Stacy Chen along with faculty reveals that nearly half of U.S. primary care practices do not consistently provide professional language services for patients with limited English proficiency (LEP), despite federal requirements mandating their availability. Using data from over 1,200 physician practices, CHAMP researchers found that practices participating in Accountable Care Organizations, those owned by hospitals or health systems, and Federally Qualified Health Centers were significantly more likely to always offer language services...

Health Equity and Hospital Markets: Differences in the Association of Market Concentration and Quality of Care by Patient Race/Ethnicity and Payer

August 30, 2025

As hospital markets across the United States continue to consolidate, a new multi-state analysis done by CHAMP trainee Alexander Adia along with CHAMP faculty Hector Rodriguez suggests that consolidation may have uneven—and sometimes harmful—effects on health equity. The study, which examined hospital market concentration and quality of care across 14 states, underscores the need for regulators to consider equity impacts when evaluating hospital mergers. The analysis found that patients from minoritized racial and ethnic groups, as well as those with noncommercial insurance coverage, faced...

Physician Organization Affiliation With Health Systems and Equitable Care Delivery

October 23, 2025

A new commentary published in JAMA Network Open by CHAMP co-director Dr. Hector Rodriguez highlights concerning findings about health system acquisitions of physician practices and their impact on vulnerable patient populations.

The commentary discusses recent research showing that when physician organizations affiliate with health systems, care disparities between dual-eligible Medicare-Medicaid beneficiaries and other Medicare patients can actually widen for certain quality measures, including diabetic eye examinations and follow-up after acute events.

"These...