Health care leaders and the public agree that covering the uninsured should be a top national priority. But until the time universal coverage is achieved, the burden of caring for the nation's most vulnerable underserved and uninsured populations will fall disproportionately on public and other safety-net hospitals. Results from several studies over the past decade have indicated that safety-net hospitals face increasing challenges to providing adequate health care for these populations. This study's goal is to identify governance practices and organizational characteristics (such as ownership or affiliation with a Medicaid managed care plan or primary care clinics) of top safety-net hospitals that lower-performing hospitals could adopt in order to raise their financial performance and quality of care. To do this, project staff will analyze audited financial statements and standardized quality measures, conduct site visits and interviews, and prepare six case studies.