232651 Safety Net Providers and Federal Health Care Reform

Wednesday, November 10, 2010 : 11:10 AM - 11:30 AM

Andrew Bindman, MD , University of California San Francisco, San Francisco, CA
Federal legislation including the Recovery Act in 2009 which supports dissemination of information technology and the Patient Protection and Affordable Care Act (PPACA) in 2010 which broadly affects health insurance coverage and targeted funding for safety net providers will have a substantial impact on the health care safety net. The demand for health care services is likely to rise following the expansion of health insurance coverage, but it is unclear what role the health care safety net will play in delivering those services. Safety net providers may become more critical as a source of care because they are located in medically underserved areas. However, the increased availability of health insurance coverage for many of those who were previously uninsured may result in a migration of patients away from the safety net toward those providers who serve privately insured populations. As a part of PPACA, safety net hospitals will experience a decrease in targeted funding under the Medicaid Disproportionate Share Hospital (DSH) fund while safety net clinics will benefit from an increase of $11 billion in new funding. To compete in the marketplace, safety net providers will need to use information technology to enhance their ability to provide efficient and high quality care. They should also consider adopting some of the policies and practices of the most successful safety net delivery systems in order to ensure their financial viability to care for those who remain most vulnerable for poor health outcomes due to lack of health insurance or other social characteristics.

Learning Areas:
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy

Learning Objectives:
Describe recent federal policy changes that will impact the financial viability of different elements of the health care safety net. Assess the role of the health care safety net following the expansion of health insurance coverage. Identify the strategies that successful health care safety net providers currently use to compete in the health care marketplace. Discuss policies and practices that health care safety net providers should adopt to ensure adequate on-going access to high quality care for the most vulnerable segments of our population.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified because I am a health care provider who has practiced in a health care safety net institution for more than 20 years; I am a health services researcher who has published on this topic many times; and I worked as a member of the Committee staff of Energy and Commerce in the US House of Representatives in 2009-2010 to pass comprehensive federal health care reform.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.