Regenstein, MarshaHuang, JenniferCummings, LindaLessler, DanielReilly, BrendanSchillinger, DeanSafety net hospital systems provide health care to a high volume of underserved patients, including uninsured and low-income patients, racial/ethnic minorities, and those with chronic conditions. To assess the effects of programs designed to improve care for the undeserved, the National Public Health and Hospital Institute interviewed administrators about available programs and services and collected information on patient demographics, health care utilization, and clinical outcomes related to diabetes management. Services range from availability of special diabetes clinics to American Diabetes Association–certified classes. Compared with other health care providers, safety net hospital systems provide comparably high quality of care to patients with diabetes, despite serving higher volumes of underserved patients. However, even with programs and services designed to improve access to care for the underserved, disparities in quality of care and patient outcomes persist as a result of demographic risk factors, most notably, lack of insurance.Access To HealthcareHealthDiabetesPracticeservicesafety net hospital systemsunderservedunisuredlow-incomeracial/ethnic minoritesNational Public Health and Hospital Institutediabetesdiabetes managementdisparitesTechnical Report