The economic recession: early impacts on health care safety net providers. 
While the recession increased demands on the health care safety net as Americans lost jobs and health insurance, the impact on safety net providers has been mixed and less severe--at least initially--than expected in some cases, according to a new study of five metropolitan communities by the Center for Studying Health System Change (HSC).  Even before the recession, many safety net providers reported treating more uninsured patients and facing tighter state and local funding.  Federal expansion grants for community health centers during the past decade, however, have increased capacity at many health centers.  And, programs to help direct people to primary care providers may have helped stem the expected surge in emergency department use by the uninsured during the downturn.  Federal stimulus funding--the 2009 American Recovery and Reinvestment Act--has assisted hospitals and health centers in weathering the economic storm, helping to offset reductions in state, local and private funding.  And, the economic downturn has generated some potential benefits, including lower rents and broader employee applicant pools.  While safety net providers have adopted strategies to stay financially viable, many believe they have not yet felt the full impact of the deepest recession since the Great Depression.