Background: Since 1996, there has been an abundance of anecdotal information that safety net providers are experiencing a shift in patient flows, changes in capacity, and financial instability as a result of managed care and other policy forces. This paper provides a better understanding of how these dynamics affect safety net provider capacity in five cities and identifies some ways to collect information on local safety nets. Methodology: The paper is based on site visits to 5 cities in a study sponsored by HRSA. Interviews were conducted with key safety net providers and others, such as state and local government officials, who have perspectives on the safety net, and financial data were obtained from some providers. Findings: The structure of the safety net varies across communities, ranging from heavy concentration in a few providers to one that involves a larger number of organizations. The capacity of the safety net is growing in some cities and shrinking in others. Similarly, there is a striking variation in how well the safety net as a whole is meeting the demand for services by the uninsured. The following factors affect the capacity of the safety net to serve the uninsured in these cities: (1) financial pressure on and organizational culture of safety net providers; (2) local funding and support; (3) Medicaid and SCHIP program policies; (4) efficiency of safety net providers, (5) availability of grant revenue (e.g., HRSA and foundations), and (6) isolation versus collaboration among safety net providers.
Learning Objectives: After the conclusion of the session, the participant (learner) will be able to: 1. Describe the structure of the safety net in 5 communities. 2. Discuss recent changes in safety net provider capacity and the effects of these changes. 3. Identify factors that affect safety net provider capacity.
Keywords: Safety Net Providers, Underserved
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: The Health Resources and Services Administration sponsored this study.
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: