Of course, unique characteristics of the Virginia regulatory environment may facilitate the ability of hospitals to achieve this balance. The Virginia Indigent Care Trust Fund provides a reward for facilities that provide certain amounts of care to uninsured patients. In addition, Virginia certificate-of-need regulation requires hospitals to provide specified amounts of care to the medically indigent as a condition of approval of hospital construction projects. Thus, the regulatory environment is conducive to encouraging indigent care provision and to achieving a balance between efficiency and indigent care provision. It is important for future research to examine hospitals in others states with different regulatory environments to determine if hospitals in other states also can maintain a reasonable balance between efficiency and uncompensated care provision.