How All-Payer Global Budgeting Can Help Safety-Net Hospitals Invest More in Community Health
<p>In 2010, Maryland launched a pilot program in which 10 rural hospitals were each guaranteed a set amount of revenue for the coming year, regardless of the number of inpatient admissions or emergency department visits. After 30 months, potentially preventable complications fell by nearly half, readmission rates dropped even further, and the hospitals had generated hundreds of millions in Medicare savings.</p><p>The emergence of all-payer global hospital budgeting may represent a solution to the challenge safety-net health care systems face in meeting their communities’ needs for expanded primary care, behavioral health, and social services. Unlike fee-for-service reimbursement, global budgeting creates an incentive for hospitals to reorganize care delivery and invest in services to address preventable health conditions.</p>
<p>In a new Commonwealth Fund report, a team of experts led by Joshua M. Sharfstein of the Johns Hopkins Bloomberg School of Public Health assesses the potential of all-payer global hospital budgeting to further the mission of safety-net health systems. The authors detail the steps to implementing global budgets while also weighing the pros and cons of pursuing global budgeting over alternative value-based payment arrangements.</p>