Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Multicenter Study
The Impact of Maryland's Global Budget Payment Reform on Emergency Department Admission Rates in a Single Health System.
In 2014, the state of Maryland (MD) moved away from fee-for-service payments and into a global budget revenue (GBR) structure where hospitals have a fixed revenue target, independent of patient volume or services provided. We assess the effects of GBR adoption on emergency department (ED) admission decisions among adult encounters. ⋯ Within the same health system, implementation of global budgeting in MD hospitals was associated with a decline in ED admissions-particularly lower-acuity admissions-compared to DC hospitals that remained under fee-for-service payments.