Specialty Care Access in the Safety Net—the Role of Public Hospitals and Health Systems

@article{Makaroun2017SpecialtyCA,
  title={Specialty Care Access in the Safety Net—the Role of Public Hospitals and Health Systems},
  author={Lena K Makaroun and Chelsea Bowman and Kevin Duan and Nathan Handley and Daniel J. Wheeler and Edgar Pierluissi and Alice Hm Chen},
  journal={Journal of Health Care for the Poor and Underserved},
  year={2017},
  volume={28},
  pages={566 - 581}
}
Access to specialty care in the United States safety net, already strained, is fac-ing increasing pressure with an influx of patients following the passage of the Affordable Care Act (ACA). We surveyed 18 public hospitals and health systems across the country to describe the current state of specialty care delivery in safety-net systems. We elicited information regarding challenges, provider models, metrics of access and productivity, and strategies for improving access. Based on our findings… 
View on PubMed
muse.jhu.edu
6 Citations

6 Citations

Citation Type

Citation Type

Specialty care access for Medicaid enrollees in expansion states.
TLDR
Assessment of current levels of difficulty accessing specialty care for CHC patients, by insurance type, and to identify specific barriers and strategies that CHCs are using to overcome these barriers found Medicaid patients at CHCs face many barriers to accessing specialist care.
Access to specialty healthcare in urban versus rural US populations: a systematic literature review
TLDR
A systematic review of literature within the CINAHL, Medline, PubMed, PsycInfo, and ProQuest Social Sciences databases published between January 2013 and August 2018 suggested several additional themes important to urban versus rural specialty care access.
High Prevalence of Cirrhosis at Initial Presentation Among Safety-Net Adults with Chronic Hepatitis B Virus Infection.
Managerial Intervention Strategies to Reduce Patient No-Show Rates
Managerial Intervention Strategies to Reduce Patient No-Show Rates by Charl Mattheus MBA, Indiana Wesleyan University, 2011 BS, Indiana Wesleyan University, 2007 Doctoral Study Submitted in Partial…
Nonmydriatic Photographic Screening for Diabetic Retinopathy in Pregnant Patients with Pre-Existing Diabetes in a Safety Net Population: 1 Year Results from the Diabetic Retinopathy in Pregnant Patients Study
TLDR
The telemedicine-based model for DR screening in pregnant patients in safety net hospitals is effective in improving screening rates and expediting evaluation and treatment for those in need and provides an effective framework for ophthalmic care in a safety net hospital system.
Telehealth Utilization in Low Resource Settings

References

SHOWING 1-10 OF 48 REFERENCES
Access to specialty care and medical services in community health centers.
TLDR
Access to specialty health services for patients receiving care in CHCs is evaluated, using a survey of medical directors of all federally qualified CHCs in the United States in 2004 to report that uninsured patients had greater difficulty obtaining access to off-site specialty services.
America's Health Care Safety Net: Intact but Endangered
America's Health Care Safety Net explains how competition and cost issues in today's health care marketplace are posing major challenges to continued access to care for Americaa (TM)s poor and…
Integrating community health centers into organized delivery systems can improve access to subspecialty care.
The Affordable Care Act is funding the expansion of community health centers to increase access to primary care, but this approach will not ensure effective access to subspecialty services. To…
Monitoring local safety-net providers: do they have adequate capacity?
TLDR
It is found that capacity was strained for specialty services and that access to pharmaceuticals was difficult, while primary care capacity was more often adequate to serve those who presented themselves for care.
Improving Access to Specialty Care for Medicaid Patients: Policy Issues and Options
In some states and communities, Medicaid programs, health plans, providers, and others are collaborating to improve timely access to medical and surgical specialty services for Medicaid enrollees.…
Not Perfect, but Better: Primary Care Providers’ Experiences with Electronic Referrals in a Safety Net Health System
TLDR
PCPs felt electronic referrals improved health-care access and quality; those who reported a negative impact on workflow were less likely to agree; while electronic referrals hold promise as a tool to improve clinical care, their impact on productivity should be considered.
Enhancing the Capacity of Community Health Centers to Achieve High Performance: Findings from the 2009 Commonwealth Fund National Survey of Federally Qualified Health Centers
Federally Qualified Health Centers (FQHCs) are community-based health centers that provide comprehensive primary care and behavioral and mental health services to patients regardless of ability to…
Increasing access to specialty care: patient discharges from a gastroenterology clinic.
TLDR
Understanding the concerns of all stakeholders is necessary to refine and disseminate this process to other specialties and healthcare systems to ensure timely access to specialty services for all patients.
Expanding access to hepatitis C virus treatment—Extension for Community Healthcare Outcomes (ECHO) project: Disruptive innovation in specialty care
TLDR
Evaluation of the ECHO program concludes that ECHO expands access to best practice care for underserved populations, builds communities of practice to enhance professional development and satisfaction of primary care clinicians, and expands sustainable capacity for care by building local centers of excellence.
eReferral--a new model for integrated care.
TLDR
One innovation prompted by clinical exigencies, eReferral, offers a new model for integrating primary and specialty care, and can help health care organizations take better care of more patients at lower cost.
...
1
2
3
4
5
...