title: Specialty Care Access in the Safety Net-the Role of Public Hospitals and Health Systems.
abstract: Access to specialty care in the United States safety net, already strained, is fac-ing increasing pressure with an influx of patients following the passage of the Affordable Care Act (ACA). We surveyed 18 public hospitals and health systems across the country to describe the current state of specialty care delivery in safety-net systems. We elicited information regarding challenges, provider models, metrics of access and productivity, and strategies for improving access. Based on our findings, we propose a framework for assessing and improving specialty care access with a focus on population health planning.
authors.forename: Lena K
authors.initials: LK
authors.lastname: Makaroun
authors.forename: Chelsea
authors.initials: C
authors.lastname: Bowman
authors.forename: Kevin
authors.initials: K
authors.lastname: Duan
authors.forename: Nathan
authors.initials: N
authors.lastname: Handley
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Wheeler
authors.forename: Edgar
authors.initials: E
authors.lastname: Pierluissi
authors.forename: Alice Hm
authors.initials: AH
authors.lastname: Chen
mesh_terms: D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006779:Hospitals, Public / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D008511:Medicine / Q000706:statistics & numerical data*; D044469:Racial Groups / Q000706:statistics & numerical data; D064876:Safety-net Providers / Q000706:statistics & numerical data*; D014481:United States; D014850:Waiting Lists