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How Did Safety-Net Hospitals Cope In The 1990s?

The hospital industry experienced financial pressure in the 1990s because of intense competition for managed care contracts and increasing efforts among all payers to contain growth in hospital payments. Despite this, U.S. hospitals provided $18.5 billion in uncompensated care in 1997.¹ Safety-net hospitals faced special challenges. The growing numbers of uninsured persons increased demand for their services. Specific efforts to contain health care spending, most notably the 1997 Balanced Budget Act (BBA), threatened subsidies that have long supported indigent care. Also, Medicaid managed care likely steered Medicaid patients away from safety-net hospitals, leaving them with proportionately more uninsured patients.²

To . . . [Full Text of this Article]

Identification of safety-net hospitals.Data sources and methods.

Characteristics Of Safety-Net Hospitals

 
Uncompensated care burden.Specialty services.

Organizational And Operational Changes

 
Closures and mergers.Changes in service provision.Operational and financial changes.

Discussion

 
Implications of service changes.Medicaid DSH payments.Impact of managed care.Staffing levels and expenses.

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