Jo Ivey Boufford, Larry Gage, Kenneth W. Kizer et al.
New Approaches to Academic Health Center Affiliations: Public Hospitals and the Department of Veterans Affairs, Jo Ivey Boufford, Larry Gage, Kenneth W. Kizer et al, The Commonwealth Fund, April 1999
In the current period of rapid change in the structure, financing, and governmental oversight of the health care delivery system, two types of health care organizations may be the most vulnerable: public hospital systems and academic health centers (AHCs). Both types of organizations must cope with unprecedented pressures to reduce costs. AHCs are especially likely to be high-cost providers of health services—25 to 40 percent higher, in fact, than non-academic centers. AHCs face decreases in traditional sources of revenue such as federal support for graduate medical education (GME); increased efforts to move GME outside the hospital setting; greater competition for new funds for biomedical research; and rising numbers of uninsured patients.