“Other than the nation’s uninsured, perhaps no set of people or entities had a bigger stake in the outcome of the Supreme Court’s decision on the Affordable Care Act than the ‘safety net,’ ” notes Editor-in-Chief Susan Dentzer in the August issue of Health Affairs. Research and analysis in this month’s issue focuses on the state of the safety net for uninsured and low-income Americans in the context of key provisions in the Affordable Care Act. The authors examine a range of issues, including how prepared safety-net hospitals and clinics are for the impending influx of new patients through health reform; whether they will succeed in attracting newly insured patients who will have the ability to access other providers; and existing problems in emergency care that warrant new solutions. Among the featured articles are an examination of “patient dumping” by Sara Rosenbaum of The George Washington University; an analysis of how governance, competition, and financial performance interplay at 150 safety-net hospitals by Nancy Kane of the Harvard School of Public Health; and a study of emergency department “boarding” by Elaine Rabin of the Mount Sinai School of Medicine. Additional articles in this issue address the causes of–and potential solutions for–large disparities in life expectancy based on race and education; the potential for savings if Medicare covered certain diabetes care for young patients; and the implications of the recent Supreme Court decision on Medicaid expansion. The following AcademyHealth members published work in this month’s issue of the journal: The Affordable Care Act Largely Survives The Supreme Court’s Scrutiny—But Barely Timothy Stoltzfus Jost ANALYSIS & COMMENTARY: The Supreme Court’s Surprising Decision On The Medicaid Expansion: How Will The Federal Government And States Proceed? Sara Rosenbaum Strained Local And State Government Finances Among Current Realities That Threaten Public Hospitals’ Profitability Sara J. Singer, Jonathan R. Clark, and Melissa Valentine How Five Leading Safety-Net Hospitals Are Preparing For The Challenges And Opportunities Of Health Care Reform Sharon K. Long Safety-Net Providers In Some US Communities Have Increasingly Embraced Coordinated Care Models Peter Cunningham Integrating Community Health Centers Into Organized Delivery Systems Can Improve Access To Subspecialty Care Kevin Grumbach, Andrew Bazemore, and Robert L. Phillips In Ten California Counties, Notable Progress In System Integration Within The Safety Net, Although Challenges Remain Nadereh Pourat, Anna C. Davis, Diana Hilberman, Dylan H. Roby, and Gerald F. Kominski The Post-Katrina Conversion Of Clinics In New Orleans To Medical Homes Shows Change Is Possible, But Hard To Sustain Diane R. Rittenhouse, Laura A. Schmidt, and Kevin J. Wu Based On Key Measures, Care Quality For Medicare Enrollees At Safety-Net And Non-Safety-Net Hospitals Was Almost Equal Joseph S. Ross, Susannah M. Bernheim, Elizabeth E. Drye, Sharon-Lise T. Normand, and Harlan M. Krumholz ANALYSIS & COMMENTARY: Case Studies At Denver Health: ‘Patient Dumping’ In The Emergency Department Despite EMTALA, The Law That Banned It Sara Rosenbaum, Lara Cartwright-Smith Solutions To Emergency Department ‘Boarding’ And Crowding Are Underused And May Need To Be Legislated Mark McClelland California Hospitals Serving Large Minority Populations Were More Likely Than Others To Employ Ambulance Diversion Renee Yuen-Jan Hsia The Promise And Peril Of Accountable Care For Vulnerable Populations: A Framework For Overcoming Obstacles Valerie A. Lewis and Elliott S. Fisher Increase In Federal Match Associated With Significant Gains In Coverage For Children Through Medicaid And CHIP Stephen W. Patrick and Matthew M. Davis Differences In Life Expectancy Due To Race And Educational Differences Are Widening, And Many May Not Catch Up John Rother Substantial Medicare Savings May Result If Insurers Cover ‘Artificial Pancreas’ Sooner For Diabetes Patients Michael J. O’Grady and Aaron Winn Medical Groups Can Reduce Costs By Investing In Improved Quality Of Care For Patients With Diabetes Bryan E. Dowd Greater Adherence To Diabetes Drugs Is Linked To Less Hospital Use And Could Save Nearly $5 Billion Annually Ashish K. Jha THE CARE SPAN: Low Cognitive Ability And Poor Skill With Numbers May Prevent Many From Enrolling In Medicare Supplemental Coverage Brian Elbel Medicare Beneficiaries Less Likely To Experience Cost- And Access-Related Problems Than Adults With Private Coverage Karen Davis, Michelle M. Doty, and Mark A. Zezza The ‘Alternative Quality Contract,’ Based On A Global Budget, Lowered Medical Spending And Improved Quality Zirui Song, Bruce E. Landon, Mary Beth Landrum, Robert E. Mechanic, and Michael E. Chernew   Health Affairs is an official journal of AcademyHealth.  

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