Download America's Health Care Safety Net: Intact But Endangered by Institute of Medicine, Managed Care, and the Future PDF

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By Institute of Medicine, Managed Care, and the Future Viability of Safety Net Providers Committee on the Changing Market, Stuart Altman, Marion Ein Lewin

"America's wellbeing and fitness Care security web" explains how pageant and value matters in brand new wellbeing and fitness care market are posing significant demanding situations to persevered entry to take care of America's negative and uninsured. At a time while policymakers and prone are urgently looking suggestions, the committee recommends concrete ideas for holding the viability of the security web - with leading edge ways to development public realization, constructing greater instruments for monitoring the matter, and designing potent interventions. This booklet examines the overall healthiness care security web from the views of key companies and the populations they serve, together with: elements of the protection internet - public hospitals, group clinics, neighborhood wellbeing and fitness departments, and federal and nation courses. Mounting pressures at the process - emerging numbers of uninsured sufferers, decline in Medicaid eligibility because of welfare reform, expanding healthiness care entry obstacles for minority and immigrant populations, and extra. particular effects for companies and their sufferers from the aggressive, controlled care surroundings - detailing the evolution and influence of Medicaid controlled care. Key matters highlighted in 4 populations are - childrens with certain wishes, individuals with severe psychological affliction, individuals with HIV/AIDS, and the homeless.

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Extra info for America's Health Care Safety Net: Intact But Endangered

Sample text

For example, in some areas a large safety net hospital could take the lead and join with other providers, including community-based clinics. A state or local government could stimulate cooperative efforts in other areas, participating with its own service-delivery capacity. In still others, coalitions of ambulatory care providers, such as CHCs allied with local private physicians, could form and undertake the initiative. , patient tracking systems, reengineering, and programs targeted to high-risk patients), and, where needed, the health care itself.

Federal and state policy makers should explicitly take into account and address the full impact (both intended and unintended) of changes in Medicaid policies on the viability of safety net providers and the populations they serve. In making this recommendation, the committee believes that the following issues need heightened public policy attention: · failure to take into consideration the impact on safety net providers of changes in Medicaid policy could have a significant negative effect on the ability of these providers to continue their mission to serve the uninsured population, particularly those who move back and forth between being eligible for Medicaid and being uninsured; · the adequacy and fairness of Medicaid managed care rates; · the erosion of the Medicaid patient base and the financial stability of core safety net providers that must continue to care for the uninsured population; · the declining ability or willingness of non-core safety net providers to provide care for the uninsured population; and the current instability of the Medicaid managed care market including the rapid entry and exit of plans and the impact of this churning of program beneficiaries.

The committee further observed that the current capacity for monitoring the status of safety net providers is inadequate for providing timely and systematic evidence about the effects of these forces. Recommendations Recommendation 1. Federal and state policy makers should explicitly take into account and address the full impact (both intended and unintended) of changes in Medicaid policies on the viability of safety net providers and the populations they serve. In making this recommendation, the committee believes that the following issues need heightened public policy attention: · failure to take into consideration the impact on safety net providers of changes in Medicaid policy could have a significant negative effect on the ability of these providers to continue their mission to serve the uninsured population, particularly those who move back and forth between being eligible for Medicaid and being uninsured; · the adequacy and fairness of Medicaid managed care rates; · the erosion of the Medicaid patient base and the financial stability of core safety net providers that must continue to care for the uninsured population; · the declining ability or willingness of non-core safety net providers to provide care for the uninsured population; and the current instability of the Medicaid managed care market including the rapid entry and exit of plans and the impact of this churning of program beneficiaries.

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