Specialty care access in the safety net—the role of public hospitals and health systems

Lena K. Makaroun, Chelsea Bowman, Kevin Duan, Nathan Handley, Daniel J. Wheeler, Edgar Pierluissi, Alice Hm Chen

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Access to specialty care in the United States safety net, already strained, is facing 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, we propose a framework for assessing and improving specialty care access with a focus on population health planning.

Original languageEnglish (US)
Pages (from-to)566-581
Number of pages16
JournalJournal of health care for the poor and underserved
Issue number1
StatePublished - Feb 2017

Bibliographical note

Publisher Copyright:
© Meharry Medical College.


  • Access to care
  • Health care reform
  • Safety net
  • Specialty care


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