NAPH recently conducted a survey of its members to measure the impact of the economic recession of safety net hospitals. This document highlights the survey findings for the third and fourth quarters of calendar year 2009. Survey findings will be updated on a quarterly basis throughout the duration of the economic recession.

Since the start of the current economic recession, safety net health systems have treated more patients overall and provided even more uncompensated care to low-income populations. This research brief explores how safety net organizations remain critical to the nation's health care system.

Results of the Annual NAPH Characteristics Survey: This Monograph examines the utilization and financial characteristics of NAPH members in 2008. Key findings include: financial challenges faced, clinical and community services provided, and profiles of patients served by member hospitals.

Results from the NAPH 2008 annual Characteristics Survey indicate safety net hospitals continued to fulfill critical roles in their communities amid the initial effects of a national economic downturn. Read more about the what the survey findings mean for the future of the safety net.

Results of the Annual NAPH Characteristics Survey: This Monograph examines the utilization and financial characteristics of NAPH members in 2007. Key findings include: financial challenges faced, clinical and community services provided, and profiles of patients served by member hospitals.

Results from the National Association of Public Hospitals and Health Systems (NAPH) annual membership characteristics survey indicate that safety net hospitals continue to fulfill critical roles in their communities.

Results of the Annual NAPH Characteristics Survey: This Monograph examines the utilization and financial characteristics of NAPH members in 2004. Key findings include: financial challenges faced, clinical and community services provided, and profiles of patients served by member hospitals.

Section 1115 of the Medicaid statute enables the Centers for Medicare and Medicaid Services (CMS) to waive compliance with certain Medicaid requirements. This paper focuses on an emerging trend among states to use Section 1115 demonstrations to restructure Medicaid payments supporting safety net providers (i.e. “safety net financing”).

In 2005, four states – Massachusetts, California, Iowa, and Florida – received approval for Section 1115 demonstration projects that restructure Medicaid safety net hospital financing. In part, this trend is an outgrowth of the Centers for Medicare and Medicaid Services' (CMS) enhanced scrutiny of Medicaid reimbursement and financing mechanisms. Section 1115 may present opportunities for states and public hospitals to preserve funding for the safety net in the face of CMS efforts to restrict or eliminate intergovermental transfers and supplemental upper payment limit (UPL) payments.

Results of the Annual NAPH Characteristics Survey: This Monograph examines the utilization and financial characteristics of NAPH members in 2003. Key findings include: financial challenges faced, clinical and community services provided, and profiles of patients served by member hospitals.

Results of the Annual NAPH Characteristics Survey: This report examines the utilization and financial characteristics of NAPH members in 2002. Key findings include: financial challenges faced, clinical and community services provided, and profiles of patients served by member hospitals.

Results of the Annual NAPH Characteristics Survey: This Monograph examines the utilization and financial characteristics of NAPH members in 2001. Key findings include: financial challenges faced, clinical and community services provided, and profiles of patients served by member hospitals.

Results of the Annual NAPH Characteristics Survey: This report examines the utilization and financial characteristics of NAPH members in 1999. Key findings include: financial challenges faced, clinical and community services provided, and profiles of patients served by member hospitals.

Results of the Annual NAPH Characteristics Survey: This report examines the utilization and financial characteristics of NAPH members in 1998. Key findings include: financial challenges faced, clinical and community services provided, and profiles of patients served by member hospitals. This report also outlines NAPH member trends, including the increasing burden of treating the uninsured, the shift from inpatient to outpatient care, increased competition for Medicaid and commercially insured patients, and reduced federal/state funding.

This chart outlines key features of select demonstration projects approved by CMS between January 2001 and December 2005.