Analysis of Options to Help Remake the Health Care Safety Net

This contract supports a detailed analysis of what is happening to the safety net of services and providers in four major cities. It combines a review of relevant documents with telephone interviews and on-site meetings. The major product of the program contract is the development of a report that details what is happening in these communities and to provide options that the Foundation could consider in helping communities respond to these changes. Specifically, the report analyzes the effect of: (1) changes in municipal and other public support of public hospitals and clinics; (2) changes in Medicaid and Medicare reimbursement (e.g., changes in disproportionate share payments); (3) the growth of Medicaid and commercial managed care on the development of health care networks; (4) market forces on the structure of primary care physician practice, including how these forces are influencing practitioners ability to provide care to the medically indigent; (5) changes in capital financing mechanisms for safety net providers; and (6) how public health departments are altering their role in this changing environment. The report investigates what mix of complementary strategies might be pursued by local and state governments, and health care providers, catalyzed by Foundation support to help remake the safety net. Foundation staff will work closely with the contractor including participating in the on-site visits to explore program options.

Grant Details

Amount Awarded $180,800.00

Awarded on: 9/27/1995

Time frame: 10/1/1995 - 4/30/1996

Grant Number: 27417


Kalkines, Arky, Zall & Bernstein LLP

1675 Broadway
New York, 10019-5820


Richard J. Zall
Project Director