State & Future of Public Hospitals

The Joint Center for Political and Economic Studies (2000) examined the status and future of urban public hospitals, noting that these institutions serve America's most vulnerable populations and provide essential services such a trauma care and burn units to the entire population of major metropolitan areas. Such institutions depend heavily upon Medicaid and Medicare populations, and upon these federal programs as well as state and local governments for financial solvency. Driven by the quality improvement movement and constrained by competition and limited funding, such institutions face myriad challenges related to workforce issues as well as service issues.

Several factors impact upon management and administration in public hospitals. Many American public hospitals are closely tied to academic medicine, and as such, have a complex mission that extends beyond patient care to include teaching, research and serving the poor. Sustaining this mission in light of declining funds and strict regulatory oversight of reimbursement policies and practices has b

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In a discussion of the governance change for metropolitan public hospitals, Edward Stolzenberg (2000) stated that public hospitals demonstrate their value to the nation's healthcare systems by filling service gaps and caring for vulnerable populations. The traditional governance of the public hospital where it is operated as an arm of government is seen by Stolzenberg (2000) as anachronistic in an environment dominated by competition and business-driven imperatives. The Medicaid population, once considered the major target population of the public hospital, has become a target for both for-profit and non-profit systems because of Medicaid-managed care. This is leading public hospital institutions to restructure governance mechanisms to create a model free of operational constraints that characterize its structure. Stolzenberg (2000) believes that public hospitals must gain greater access to capital, achieve extraction from the body politic, acquire financial management autonomy, and develop the capacity to network and enter upon joint ventures. In this context, such institutions are seen as facing the need to bolster and support the workforce with competitive wage and benefit packages while enhancing staffing and using inno
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Approximate Word count = 2091
Approximate Pages = 8 (250 words per page)

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