title: Safety-net providers in some US communities have increasingly embraced coordinated care models.
abstract: Safety-net organizations, which provide health services to uninsured and low-income people, increasingly are looking for ways to coordinate services among providers to improve access to and quality of care and to reduce costs. In this analysis, a part of the Community Tracking Study, we examined trends in safety-net coordination activities from 2000 to 2010 within twelve communities in the United States and found a notable increase in such activities. Six of the twelve communities had made formal efforts to link uninsured people to medical homes and coordinate care with specialists in 2010, compared to only two communities in 2000. We also identified key attributes of safety-net coordinated care systems, such as reliance on a medical home for meeting patients' primary care needs, and lingering challenges to safety-net integration, such as competition among hospitals and community health centers for Medicaid patients.
authors.affiliation: Center for Studying Health System Change in Washington, DC, USA. pcunningham@hschange.org
authors.forename: Peter
authors.initials: P
authors.lastname: Cunningham
authors.forename: Laurie
authors.initials: L
authors.lastname: Felland
authors.forename: Lucy
authors.initials: L
authors.lastname: Stark
mesh_terms: D003153:Community Health Services / Q000458:organization & administration*; D019058:Community Networks; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration* / Q000639:trends; D004465:Economic Competition; D006297:Health Services Accessibility / Q000458:organization & administration* / Q000639:trends; D017057:Medically Uninsured / Q000706:statistics & numerical data; D017146:Models, Organizational; D011320:Primary Health Care / Q000458:organization & administration; D012017:Referral and Consultation / Q000458:organization & administration; D017664:Uncompensated Care / Q000706:statistics & numerical data; D014481:United States; D019037:Urban Health Services / Q000458:organization & administration / Q000639:trends