In the short-term following the passage of healthcare reform, we can expect an improvement in children's access to primary care services and the benefits of a medical home, as well as a shift to government-insured coverage, which will pose operational and profitability challenges for children's hospitals, writes Sg2 Senior Analyst Gretchen Proesel. In the long-term we can expect reductions in disproportionate share payments, which will challenge children's hospitals' bottom lines and their ability to provide nonprofitable services, she adds.