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dc.contributor.authorStryckman, Benoit
dc.contributor.authorKuhn, Diane
dc.contributor.authorGingold, Daniel B
dc.contributor.authorFischer, Kyle R
dc.contributor.authorGatz, J David
dc.contributor.authorSchenkel, Stephen M
dc.contributor.authorBrowne, Brian J
dc.date.accessioned2021-10-15T16:51:31Z
dc.date.available2021-10-15T16:51:31Z
dc.date.issued2021-09-02
dc.identifier.urihttp://hdl.handle.net/10713/16849
dc.description.abstractReducing cost without sacrificing quality of patient care is an important yet challenging goal for healthcare professionals and policymakers alike. This challenge is at the forefront in the United States, where per capita healthcare costs are much higher than in similar countries around the world. The state of Maryland is unique in the hospital financing landscape due to its "capitation" payment system (also known as "global budget"), in which revenue for hospital-based services is set at the beginning of the year. Although Maryland's system has yielded many benefits, including reduced Medicare spending, it also has had unintentional adverse consequences. These consequences, such as increased emergency department boarding and ambulance diversion, constrain Maryland hospitals' ability to fulfill their role as emergency care providers and act as a safety net for vulnerable patient populations. In this article, we suggest policy remedies to mitigate the unintended consequences of Maryland's model that should also prove instructive for a variety of emerging alternative payment mechanisms.en_US
dc.description.urihttps://doi.org/10.5811/westjem.2021.5.51889en_US
dc.language.isoenen_US
dc.publishereScholarshipen_US
dc.relation.ispartofWestern Journal of Emergency Medicineen_US
dc.subject.meshCapitation Feeen_US
dc.subject.meshPatient Care--economicsen_US
dc.subject.meshMarylanden_US
dc.titleBalancing Efficiency and Access: Discouraging Emergency Department Boarding in a Global Budget Systemen_US
dc.typeArticleen_US
dc.identifier.doi10.5811/westjem.2021.5.51889
dc.identifier.pmid34546898
dc.source.volume22
dc.source.issue5
dc.source.beginpage1196
dc.source.endpage1201
dc.source.countryUnited States


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