title: How five leading safety-net hospitals are preparing for the challenges and opportunities of health care reform.
abstract: Safety-net hospitals will continue to play a critical role in the US health care system, as they will need to care for the more than twenty-three million people who are estimated to remain uninsured after the Affordable Care Act is implemented. Yet such hospitals will probably have less federal and state support for uncompensated care. At the same time, safety-net hospitals will need to reposition themselves in the marketplace to compete effectively for newly insured people who will have a choice of providers. We examine how five leading safety-net hospitals have begun preparing for reform. Building upon strong organizational attributes such as health information technology and system integration, the study hospitals' preparations include improving the efficiency and quality of care delivery, retaining current and attracting new patients, and expanding the medical home model.
authors.affiliation: Health Policy Center at Urban Institute in Washington, DC, USA. tcoughlin@urban.org
authors.forename: Teresa A
authors.initials: TA
authors.lastname: Coughlin
authors.forename: Sharon K
authors.initials: SK
authors.lastname: Long
authors.forename: Edward
authors.initials: E
authors.lastname: Sheen
authors.forename: Jennifer
authors.initials: J
authors.lastname: Tolbert
mesh_terms: D019033:Delivery of Health Care, Integrated / Q000458:organization & administration; D018166:Health Care Reform; D006285:Health Planning / Q000458:organization & administration; D006297:Health Services Accessibility; D006779:Hospitals, Public / Q000191:economics / Q000458:organization & administration*; D006784:Hospitals, Teaching / Q000458:organization & administration; D006801:Humans; D008483:Medical Assistance / Q000706:statistics & numerical data; D008490:Medical Informatics / Q000458:organization & administration; D017057:Medically Uninsured / Q000706:statistics & numerical data; D009096:Multi-Institutional Systems / Q000458:organization & administration; D019982:Organizational Case Studies; D058991:Patient Protection and Affordable Care Act / Q000331:legislation & jurisprudence; D018802:Patient-Centered Care / Q000458:organization & administration; D036301:Qualitative Research; D014481:United States