America's hospitals are vital to meeting the health care needs of the communities they serve by providing a wide range of acute-care and diagnostic services, supporting public health needs, and offering myriad other community services to promote the health and well-being of the community. While many of these services also are provided by other health care providers, three things make the role of the hospital unique:

• 24/7 ACCESS TO CARE: The provision of health care services, including specialized resources, 24 hours a day, seven days a week (24/7), 365 days a year;
• THE SAFETY NET ROLE: Caring for all patients who seek emergency care, regardless of ability to pay; and
• DISASTER READINESS AND RESPONSE: Ensuring that staff and facilities are prepared to care for victims of large-scale accidents, natural disasters, epidemics and terrorist actions.

These critical functions while often taken for granted, represent an essential component of our nation's health and public safety infrastructure. However, this role is not explicitly funded and hospitals face increasing challenges in maintaining it.

This report explores the unique role of hospitals and its critical importance to the health care system; analyzes the nature of demand and the basic and specialized resources required to meet it; outlines the capacity and financing pressures hospitals face in maintaining this role; and frames critical economic and policy questions that must be addressed to ensure future hospital capacity can meet the growing health and public safety challenges.