TY - JOUR
T1 - Small town health care safety nets
T2 - Report on a pilot study
AU - Taylor, Pat
AU - Blewett, Lynn
AU - Brasure, Michelle
AU - Call, Kathleen Thiede
AU - Larson, Eric
AU - Gale, John
AU - Hagopian, Amy
AU - Hart, L. Gary
AU - Hartley, David
AU - House, Peter
AU - James, Mary Katherine
AU - Ricketts, Thomas
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2003
Y1 - 2003
N2 - Context: Very little is known about the health care safety net in small towns, especially in towns where there is no publicly subsidized safety-net health care. Purpose: This pilot study of the primary care safety net in 7 such communities was conducted to start building knowledge about the rural safety net. Methods: Interviews were conducted and secondary data collected to assess the community need for safety-net care, the health care safety-net role of public officials, and the availability of safety-net care at private primary care practices and its financial impact on these practices. Findings: An estimated 20% to 40% of the people in these communities were inadequately insured and needed access to affordable health care, and private primary care practices in most towns played an important role in making primary care available to them. Most of the physician practices were owned or subsidized by a hospital or regional network, though not explicitly to provide charity care. It is likely this ownership or support enabled the practices to sustain a higher level of charity care than would have been possible otherwise. In the majority of communities studied, the leading public officials played no role in ensuring access to safety-net care. Conclusions: State and national government policy makers should consider subsidy programs for private primary care practices that attempt to meet the needs of the inadequately insured in the many rural communities where no publicly subsidized primary safety-net care is available. Subsidies should be directed to physicians in primary care shortage areas who provide safety-net care; this will improve safety-net access and, at the same time, improve physician retention by bolstering physician incomes. Options include enhanced Medicare physician bonuses and grants or tax credits to support income-related sliding fee scales.
AB - Context: Very little is known about the health care safety net in small towns, especially in towns where there is no publicly subsidized safety-net health care. Purpose: This pilot study of the primary care safety net in 7 such communities was conducted to start building knowledge about the rural safety net. Methods: Interviews were conducted and secondary data collected to assess the community need for safety-net care, the health care safety-net role of public officials, and the availability of safety-net care at private primary care practices and its financial impact on these practices. Findings: An estimated 20% to 40% of the people in these communities were inadequately insured and needed access to affordable health care, and private primary care practices in most towns played an important role in making primary care available to them. Most of the physician practices were owned or subsidized by a hospital or regional network, though not explicitly to provide charity care. It is likely this ownership or support enabled the practices to sustain a higher level of charity care than would have been possible otherwise. In the majority of communities studied, the leading public officials played no role in ensuring access to safety-net care. Conclusions: State and national government policy makers should consider subsidy programs for private primary care practices that attempt to meet the needs of the inadequately insured in the many rural communities where no publicly subsidized primary safety-net care is available. Subsidies should be directed to physicians in primary care shortage areas who provide safety-net care; this will improve safety-net access and, at the same time, improve physician retention by bolstering physician incomes. Options include enhanced Medicare physician bonuses and grants or tax credits to support income-related sliding fee scales.
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U2 - 10.1111/j.1748-0361.2003.tb00553.x
DO - 10.1111/j.1748-0361.2003.tb00553.x
M3 - Article
C2 - 12696848
AN - SCOPUS:0037345062
SN - 0890-765X
VL - 19
SP - 125
EP - 134
JO - Journal of Rural Health
JF - Journal of Rural Health
IS - 2
ER -