Staying in the Game:

Health System Change Challenges Care for the Poor

Research Report No. 03
March 1999
Raymond J. Baxter, Rachel L. Feldman

his work was done in collaboration with The Center for Studying Health System Change. The Center is supported by the Robert Wood Johnson Foundation and affiliated with Mathematica Policy Research, Inc. The authors are indebted to the contribution of Robin Omata, Ph.D, The Lewin Group, for her insight about similarities and differences in how health system change affects traditional providers of care to the poor versus other providers. The authors also acknowledge the careful review and editing of Paul Ginsburg, HSC, and Linda Kohn, Institute of Medicine (formerly of HSC).

Contents

Abstract

Introduction

Methods

Organization of Care for the Poor and Uninsured

Adaptation and Survival Strategies

Conclusion

©1999 Center for Studying Health System Change