Overview

Public hospitals are disproportionate providers of health care to America's indigent and minority populations. These institutions face an increasingly hostile environment, marked by budget reductions, rapid growth of Medicaid managed care, and an ideology that promotes privatization of the safety net. To survive, public hospitals must overcome problems of financing, quality, and governance that weaken their competitiveness in the changing marketplace. Priority reforms include governance restructuring, management upgrades, new hospital and physician relationships and increased workforce flexibility. Also needed are effective advocacy and more research on safety-net care. For supporters of public hospitals, openness to change is crucial: health care for millions of Americans may hang in the balance.

Citation