Impact of Maryland’s Hospital Global Budgets on Utilization, Quality, and Spending

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In 2010, Maryland introduced a new payment program that establishes global budgets for each of the state’s acute care hospitals. Each hospital is given a fixed budget to care for all patients they serve and is held financially accountable for excess admissions, readmissions, and complications of care. Maryland’s program has the potential to improve the health of the state’s population while reducing growth in health care spending. The project team will evaluate health care utilization and spending of Medicare beneficiaries before and after the introduction of Maryland’s hospital global budget program, comparing results with those for a matched control group of beneficiaries selected from similar hospital areas in other states. The team will use Medicare claims data from 2007 to 2015 and data from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) to evaluate changes in inpatient and outpatient utilization and spending and changes in care quality and coordination. They also will seek evidence for any unintended consequences for patient care. In addition, the team will investigate associations between outcomes and patient sociodemographic and hospital characteristics. The evaluation’s first phase, using data from 2007 to 2014, will look at the first eight hospitals involved in the program, allowing for a longer post-implementation period. The second phase, which will incorporate 2015 Medicare data and will cover the remaining hospitals in the program, will encompass larger and more diverse patient populations and hospital settings.

Grant Details

Grantee Organization:
President and Fellows of Harvard College
Principal Investigator:
Ateev Mehrotra, M.D., M.P.H.
Award Amount:
$235,891.00
Approval Date:
April 12, 2016

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