Safety-net providers expected to play big role after ACA, survey finds

Nearly all health and healthcare policy leaders say they believe traditional safety-net providers – such as public hospitals, community health centers and faith-based organizations – will play a crucial role in the healthcare system of the United States after the Affordable Care Act goes into effect, found a recent survey conducted by The Commonwealth Fund and Modern Healthcare. 

Of those surveyed, 98 percent said safety-net providers will fulfill a critical need by serving individuals who remain uninsured and by providing culturally competent care and translation services. 

When asked how the ACA will affect vulnerable populations, 68 percent of respondents said it will improve access to care and 67 percent said it will improve financial protection for these groups.

“The Affordable Care Act is a major step forward toward our goal of reducing disparities in health and healthcare for vulnerable populations,” Commonwealth Fund President Karen Davis said in a statement. “But, even after the new law is fully implemented, there will be an ongoing need for safety-net providers. Healthcare leaders recognize that safety-net institutions are a vital part of the healthcare system and essential to the continued good health and good healthcare of vulnerable populations.”

"There are two primary reasons why safety-net providers will still be very important after health reform is fully implemented. First, they will be needed to help serve the remaining uninsured – projected to be approximately 23 million non-elderly Americans in 2021," said Anthony Shih, MD, MPH, executive vice president for programs at The Commonwealth Fund. "Secondly, many safety-net providers are best equipped to deal with the complex needs of their vulnerable patient populations – both medically complex (physical and mental), as well as social issues such as homelessness, low literacy, limited English proficiency, cross-cultural issues and transportation."

Other key survey findings include:

• 86 percent of respondents support strategies designed to improve the quality of care that vulnerable populations receive from safety-net providers, including transportation and translation services.

• 83 percent support facilitating the adoption and spread of patient-centered medical homes.

• 82 percent of respondents support moving toward integrated models of care.

• 74 percent of respondents support using performance-based payments to make providers more accountable for the care they provide.

• 47 percent support the adoption and spread of accountable care organizations.

• 70 percent of respondents support policies that would guarantee access to preventive, primary and acute care for undocumented immigrants.

• 17 percent of respondents oppose policies that would guarantee access to preventive, primary and acute care for undocumented immigrants.