NEJM December 31, 2020
Defining what counts as a safety-net hospital has long been a challenging but critical issue in U.S. health policy. The Covid-19 pandemic has brought this subject to the fore, as Congress and the Department of Health and Human Services (HHS) have struggled to operationalize a strategy for distributing Covid-19 relief funds to the hospitals that need them most. U.S. safety-net hospitals provide essential care to patients regardless of their insurance coverage, financial circumstances, or immigration status. The disproportionate share of uncompensated care that these hospitals provide often leads them to operate with thin financial margins while assuming responsibility for providing services that are critical but often unprofitable, including inpatient psychiatric services, neonatal intensive care, and burn and trauma care. In...