The Influence of the United States Health Care Environment and Reform on Academic Medical Centers

Academic medical centers (AMC) provide care for most of the underinsured populations of the United States. Their large size and the high acuity of cases make AMCs vulnerable to changes in health care policy. They also are the primary centers for health care research and education and are therefore heavily dependent on federal programs and funding. Since the passage of the Affordable Care Act, AMCs have seen a decrease in the number of patients without insurance. They have also participated in the implementation of alternative payment models, including accountable care organizations, with mixed success.