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University of Iowa News Release


June 6, 2011

Public Policy Center to study impact of health care reform on Iowa's safety net providers

The University of Iowa Public Policy Center (PPC) has received a grant from the Commonwealth Fund to determine how Iowa's health care safety net will be impacted by health care reform.

This Commonwealth Fund grant was one of four awarded in the nation focusing on health care reform and safety nets. Grants to Harvard University, the RAND Corporation, and the National Academy for State Health Policy (NASHP) will evaluate the impact of health care reform on providers on the national level, while the PPC grant will use Iowa as a model to study impacts at the state and local levels.

The $169,766 grant to the PCC will fund an 18-month project to examine the effect of the Affordable Care Act (ACA) on the primary care safety net of medical, dental, mental health and pharmacy providers in Iowa, as well as other related services in that deliver health care to uninsured, Medicaid and other vulnerable patients.

UI researchers in collaboration with an advisory group of state officials and providers will convene to determine the current funding, expenditures, and infrastructure of Iowa's safety net, and then develop strategies for improving it. A national advisory committee will also be formed with representatives from RAND, NASHP, the National Association of Community Health Centers and several other organizations.

"One of the challenges for achieving a fully effective health system is how to address the needs of people in special circumstances, such as rural residence, living with complex diseases or economic problems.  Historically these needs have been addressed through efforts such as rural health clinics, maternal and child health or Ryan White funding (a program in support of people living with HIV/AIDS). However, with the passage of the ACA, the future of these programs is unclear. This study will bring attention to potential gaps and help us develop solutions to problems before they affect people's lives," said Christopher Atchison, director of the State Hygienic Laboratory, associate dean for Public Health Practice and clinical professor in health management and policy at the UI College of Public Health. Atchison will serve on the advisory group.

States and local governments are partially responsible for ensuring that vulnerable populations have access to quality health care, but many have not systematically analyzed their policies and programs and may be ill-prepared to seize new opportunities in the ACA for strengthening their health care safety nets, said Public Policy Center Director Pete Damiano, who is leading the project.

"The results of the project will serve as a model that other states could use to achieve a high performance health care system for their vulnerable populations," he added.

Public Policy Center and College of Public Health faculty and staff will conduct an economic analysis of the implications of the ACA, and UI College of Law faculty will give a legal analysis. At the conclusion of the project, the Public Policy Center will provide reports on how the act will impact both safety net providers and their finances. The reports will also offer recommendations for improving the funding of and delivery of health care services by these providers.

The Wellmark Foundation has approved a $20,000 additional grant to supplement Commonwealth Fund support for this Iowa-based project. "It's been the mission of the Wellmark Foundation to help improve the health status of Iowans since 1991. We're proud to support a project that will ultimately improve and strengthen Iowa's health safety net infrastructure and serve as a model for other states," said Matt McGarvey, director of the Wellmark Foundation.

"The Iowa Collaborative Safety Net Provider Network and its partners are honored to be part of this important project. The Network was created in 2005 by the Iowa Legislature for the purpose of bringing safety net providers together to improve access to health services, the quality of patient care, and the health of underserved patients in Iowa. This project provides a tremendous opportunity to work with the Commonwealth Fund, the University of Iowa, and safety net providers from across the state to further the mission of the Network," said Theodore J. Boesen, Jr., executive director of the Iowa Primary Care Association, which coordinates the network.

Established in 1990, the Health Policy Research Program at the UI Public Policy Center investigates the effects of policy initiatives and government activities on cost of, access to, and quality of health care systems that affect consumers throughout Iowa and the nation. It is also concerned with the impact of health policy on health care providers, policymakers and businesses.

The mission of The Commonwealth Fund is to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults. The fund carries out this mandate by supporting independent research on health care issues and making grants to improve health care practice and policy.

The Wellmark Foundation is a non-profit foundation that seeks to improve the health of Iowans, South Dakotans, and their communities. The foundation provides support to nonprofit organizations and public entities to help local communities establish or expand health initiatives.

See for a summary of the project, entitled "Strategies in Iowa for Improving Performance of the Health Care Safety Net in the Era of Health Reform."

STORY SOURCE: University of Iowa News Service, 300 Plaza Centre One, Iowa City, Iowa 52242-2500

MEDIA CONTACTS: Peter Damiano, UI Public Policy Center, 319-335-6800,; George McCrory, University News Services, 319-384-0012,