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Funding Safety Net Hospitals: Commonwealth

Funding Safety Net Hospitals: Commonwealth

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Published by Patricia Dillon
1584 Bachrach
1584 Bachrach

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Published by: Patricia Dillon on Mar 12, 2012
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11/19/2012

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Toward a High Performance HealthCare System for Vulnerable Populations:Funding for Safety-Net Hospitals
Prepared for the Commonwealth Fund Commissionon a High Performance Health SystemDeborah Bachrach, Laura Braslow, and Anne Karl
 Manatt Health Solutions
March 2012
 
COVER PHOTO©
Dann Tardi/Corbis
the
 
commonwealth
 
fund
, among the frst private oundations started by a woman philanthropist—Anna M. Harkness—was established in 1918 with the broad charge to enhance the common good.The mission o The Commonwealth Fund is to promote a high perorming health care system that achieves better access,improved quality, and greater efciency, particularly or society’s most vulnerable, including low-income people, the uninsured,minority Americans, young children, and elderly adults.The Fund carries out this mandate by supporting independent research on health care issues and making grants to improvehealth care practice and policy. An international program in health policy is designed to stimulate innovative policies and practicesin the United States and other industrialized countries.
the
 
commonwealth
 
fund
 
commission
 
on
 
a
 
high
 
performance
 
health
 
system
Membership
David Blumenthal, M.D., M.P.P.
Chair of the Commission
Samuel O. Thier Proessor o Medicine and Proessor o HealthCare Policy 
Massachusetts GeneralHospital/Partners HealthCare Systemand Harvard Medical School
Maureen Bisognano, M.Sc.
President and Chie Executive Ofcer 
Institute for Healthcare Improvement
Sandra Bruce, M.S.
President and Chie Executive Ofcer 
Resurrection Health Care
Christine K. Cassel, M.D.
President and Chie Executive Ofcer 
American Board of Internal Medicineand ABIM Foundation
Michael Chernew, Ph.D.
Proessor 
Department of Health Care PolicyHarvard Medical School
John M. Colmers, M.P.H.
Vice President 
Health Care Transformation andStrategic PlanningJohns Hopkins Medicine
Patricia Gabow, M.D.
Chie Executive Ofcer 
Denver Health
Glenn M. Hackbarth, J.D.
Consultant 
George C. Halvorson
Chairman and Chie Executive Ofcer 
Kaiser Foundation Health Plan, Inc.
Jon M. Kingsdale, Ph.D.
Consultant 
Gregory P. Poulsen, M.B.A.
Senior Vice President 
Intermountain Health Care
Neil R. Powe, M.D., M.P.H., M.B.A.
Chie, Medical Services
San Francisco General Hospital
Constance B. Wosy Distinguished Proessor and Vice-Chair o Medicine
University of California, San Francisco
Louise Y. Probst, R.N., M.B.A.
Executive Director 
St. Louis Area Business HealthCoalition
Martín J. Sepúlveda, M.D., FACP
IBM Fellow and Vice President 
Integrated Health ServicesIBM Corporation
David A. Share, M.D., M.P.H.
Vice President 
Value PartnershipsBlue Cross Blue Shield of Michigan
Glenn D. Steele, Jr., M.D., Ph.D.
President and Chie Executive Ofcer 
Geisinger Health System
Alan R. Weil, J.D., M.P.P.
Executive Director 
National Academy for State HealthPolicy
Stuart Guterman
Executive Director 
Vice President for Paymentand System ReformThe Commonwealth Fund
Cathy Schoen, M.S.
Research Director 
Senior Vice President forResearch and EvaluationThe Commonwealth Fund
Rachel Nuzum, M.P.H.
Senior Policy Director 
Vice President for Federaland State Health PolicyThe Commonwealth Fund
 
 
TOWARD A HIGH PERFORMANCE HEALTH CARESYSTEM FOR VULNERABLE POPULATIONS:FUNDING FOR SAFETY-NET HOSPITALS
PREPARED FOR THE COMMONWEALTH FUNDCOMMISSION ON A HIGH PERFORMANCE HEALTH SYSTEMDeborah Bachrach, Laura Braslow, and Anne KarlManatt Health SolutionsMarch 2012
ABSTRACT:
Safety-net hospitals play an indispensable role in providing care to vulnerablepopulations. Yet, in the current economic environment, many safety-net hospitals face direfinancial circumstances and struggle to provide care to growing numbers of low-income,uninsured, and Medicaid patients. This report, written on behalf of the Commonwealth FundCommission on a High Performance Health System, examines the funding streams on whichsafety-net hospitals rely and suggests strategies
 — 
not simply to sustain these hospitals but tostimulate and reward high performance. These strategies include: increasing Medicaid rates (instates that have unreasonably low rates) to safety-net hospitals with the highest shares of Medicaid and uninsured patients and lowest shares of privately insured patients, contingent uponmeeting performance benchmarks; targeting Medicaid and Medicare disproportionate sharehospital payments to hospitals that serve uninsured patients; and supporting safety-
net hospitals’
access to the capital they need to implement large-scale delivery system reforms.Support for this research was provided by The Commonwealth Fund. The views presented hereare those of the authors and not necessarily those of The Commonwealth Fund or its directors,officers, or staff, or of the Commonwealth Fund Commission on a High Performance HealthSystem. This and other Fund publications are available online atwww.commonwealthfund.org.  To learn more about new publications when
they become available, visit the Fund’s Web site and
register to receive e-mail alerts.Commonwealth Fund pub. no. 1584.

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