Our expert answers 3 Questions
Currently, my research is focused in two main areas. The first is learning how safety net hospitals are impacted by various components of the Affordable Care Act. How are these hospitals performing in states that expanded Medicaid versus those that did not? How is care delivery changing at safety net hospitals? The second is to understand the impact of Accountable Care Organizations (ACOs) on healthcare cost and quality. Will ACOs be successful in the long run? Are there certain organizational attributes (e.g., participation of hospitals, governance by physicians vs. hospital administrators, incorporation of a broad range of physicians vs. mainly primary care physicians) that influence their overall ability to improve care at a lower cost?
My interest in safety net hospitals grew during my residency training at Grady Memorial Hospital, a large urban public hospital that provides healthcare for underserved patients in the region. From my work here, I was able to better understand some of the challenges that hospitals face in caring for vulnerable populations and some of the ways we can overcome these barriers to provide high quality healthcare for all. I find ACOs fascinating because the policies outlining the development of ACOs are broadly written, which gives these organizations significant flexibility in how each is constructed. This has led to wide variability in the composition of ACOs and physician engagement, which may impact their success over time.
Ensuring that safety net hospitals remain financially viable over time is crucial to maintaining a usual source of care for vulnerable populations and improving access to high-quality healthcare. For ACOs, a better understanding of organizational attributes that make for a successful ACO will improve the ability of organizations to come together and engage physicians to provide lower cost, higher quality care.