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Medicine and Public Policy |

The Balanced Budget Act of 1997: Its Impact on U.S. Teaching Hospitals

Robert Dickler, MHA; and Gina Shaw, BA
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From the Association of American Medical Colleges, Washington, D.C.


Acknowledgments: The authors thank Robert D'Antuono, Karen Fisher, and Ernest Valente of the Division of Health Care Affairs at the Association of American Medical Colleges for their review of the material to ensure accuracy and clarity.

Requests for Single Reprints: Gina Shaw, BA, Association of American Medical Colleges, 2450 N Street NW, Washington, DC 20037.

Requests To Purchase Bulk Reprints (minimum, 100 copies): the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints@mail.acponline.org.

Current Author Addresses: Mr. Dickler and Ms. Shaw: Association of American Medical Colleges, 2450 N Street NW, Washington, DC 20037.


Ann Intern Med. 2000;132(10):820-824. doi:10.7326/0003-4819-132-10-200005160-00010
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The Balanced Budget Act of 1997 had a profound impact on the financing and organization of many health care services. The Act disproportionately affected U.S. teaching hospitals, leading to substantial budget reductions in many institutions and the threat of cuts in major programs and services that teaching hospitals provide to communities. This paper examines the overall financial and organizational impact of the Balanced Budget Act on teaching hospitals and considers its effect on residency education. It also discusses to what degree the Balanced Budget Refinement Act of 1999 will mitigate these effects and posits other solutions to the serious financial issues facing teaching hospitals in the United States.

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