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| March 1999 Research Report No. 03 |
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Association Leaders Speak Out on Health System Change Health Affairs |
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The Community Snapshots Project Compilation of Snapshots |
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Snapshots of Change in Fifteen Communities:
Effects of Health System Changes on Safety-Net Providers
Summer 1996
Health Affairs, vol.15, no.2 (Summer 1996): 33-48
Debra J. Lipson, Naomi Naierman
rowing competition in health care markets and Medicaid managed care,
combined with cuts in government funds that subsidize care to the uninsured, are
challenging the viability of the safety net. In response to these pressures, "safety
net" providers in fifteen communities are integrating vertically and horizontally,
contracting with or forming managed care plans, and seeking to attract paying patients.
Such strategies appear to be successful for community- based primary care clinics, but
other providers - including hospitals that cannot quickly develop primary care capacity,
most local health departments, and providers that fail to attract Medicaid patients - are
more vulnerable to health system changes. While the safety net may be intact now, access
to care among the uninsured is more at risk in communities without state programs of local
taxes that subsidize such care.
Free access to this article is available at the Health Affairs Web site.
