Despite the significant reduction in uninsurance levels in Massachusetts that occurred with health care reform, the demand for care at safety-net facilities continues to rise. Most safety-net patients do not view these facilities as providers of last resort; rather, they prefer the types of care that are offered there. It will continue to be important to support safety-net providers, even after health care reform programs are established.

To the extent that health information technology (IT) improves health care quality, differential adoption among providers that serve vulnerable populations may exacerbate health disparities. This first national survey of federally funded community health centers (CHCs) shows that although 26 percent reported some electronic health record (EHR) capacity and 13 percent have the minimal set of EHR functionalities, CHCs serving the most poor and uninsured patients were less likely to have a functional EHR. CHCs cited lack of capital as the top barrier to adoption. Ensuring comparable health IT capacity among providers that disproportionately serve disadvantaged patients will have increasing relevance for disparities; thus, monitoring adoption among such providers should be a priority. [Health Affairs 26, no. 5 (2007): 1373-1383 10.1377/hlthaff.26.5.1373 E s t i m at e s o f health information technology (IT) adoption differ as a result of variable definitions, sampling techniques, and data quality; however, the broad consensus is that health IT-and electronic health records (EHRs) in particular-can greatly improve health care quality, safety, and efficiency. 1 The potential to reduce health disparities also has been frequently noted. 2 At least one recent study has documented significant quality improvements achieved by community health centers (CHCs) through the use of electronic patient registries. 3 New federal initiatives have also emphasized the critical role of health IT in realizing the future potential of genomic medicine to improve clinical care. 4 Recent analyses report adoption rates ranging from 9 percent to 24 percent, de-

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Community health centers reach their fiftieth anniversary in 2015, along with Medicaid. Health policy makers have understood the programs' symbiotic connection from the earliest days of their implementation. Medicaid's expansion and growth have made the modern community health center program possible, while health centers represent one of the principal sources of primary care for the nation's Medicaid population. With their shared mission and high level of interdependence, Medicaid and community health centers are essential for continued health system transformation in medically underserved communities nationwide--for example, by implementing delivery system reforms aimed at increasing clinical integration and improving efficiencies and by becoming medical homes for high-risk patients. Achieving this transformation will depend on the ability of community health centers and Medicaid to understand and respond to the challenges that each faces, while fully deploying the strengths that each has to offer.