Primary care providers to the poor have a better chance of becoming sustainable and more competitive when that provider has full knowledge of its practice capability and capacity, can evaluate its operations, and can proactively respond to changes in the environment. Infrastructure improvements can assist in developing and redesigning providers' operating systems to reduce costs, increase efficiency, and adapt to changing economic conditions.

The Role of Collaboration
On top of problems that result from insurance and funding issues, primary care providers to the poor have to vercome geographical and cultural barriers as well as staff shortages. Urban and rural networks and coalitions that promote sharing of information, development of interventions, and advocacy can help providers address the barriers they face.

While some mandated or legal distinctions among providers exist because of political or geographical boundaries, collaboration among these distinct groups can be mutually beneficial. This collaboration may involve sharing patients, ideas, support, and resources.

Resource Development
Because of their busy workloads, primary care providers to the poor often do not have time to search out the esources that can help them provide better, more efficient care. Through collaboration, providers can develop the resources they need, including more efficient practice operations, sustainable infrastructures, strengthened skill sets of staff, links with business and other organizations, and an increased understanding of policy and funding issues affecting access for the uninsured. Primary care providers can take advantage of advanced technology to share resources, such as computers and medical equipment, that they would not be able to afford by themselves. This would allow the primary care providers to the poor to remain on the cutting edge of medical practice and would help them be competitive.

Developing Infrastructure and Systems
To assist primary care providers to the poor in developing infrastructure and effective systems, the Foundation will support activities such as the following:

• Development of collaborative relationships and shared resources
• Development and implementation of activities that strengthen providers' ability to sustain or expand their practices
• Use of emerging technologies that may enhance practice management and improve access to services
• Strengthening the organizational leadership and business skills of managers