222EMF Effects of the Global Budget Revenue Model on Emergency Department Utilization and Quality

Abstract

In 2014, Maryland (MD) launched an innovative statewide reform that replaced fee-for-service hospital payments with a “global budget revenue” (GBR) model. GBR prospectively determines an annual budget for each hospital, incentivizing hospitals to closely meet revenue targets and prevent avoidable admissions. In prior work, our team has demonstrated a relative decline in ED admission rates among GBR hospitals compared to controls that remained fee-for-service as well as post-GBR investments in ED care coordination.