Harm reduction centers — where drug users and sex workers can get clean needles, syringes, free condoms and HIV prevention information — have existed for decades. They've generally operated on the outskirts of the health care system and pieced together shoestring budgets with the help of state and federal programs as well as private donations. Robert Cordero, outgoing president and chief program officer for New York City's BOOM!Health, says this opportunity is new — and very real. But harm reduction centers are increasingly trying to reposition themselves as a commodity for hospitals and insurers because of their unique experience in coordinating care for high-risk and often marginalized patients.