ArticleHealthcare (Amsterdam, Netherlands)2020
The impact of global budget payment reform on systemic overuse in Maryland.
Article in Healthcare (Amsterdam, Netherlands), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed.
- The impacts of the diagnosis-related group payment reform on hospitalization-related medical expenses: evidence from China.Health economics review · 2025Article
- Examining the factors associated with inpatients' perception of overtreatment in Korea: a cross-sectional study.BMC health services research · 2023Article
- A Policy Approach to Reducing Low-Value Device-Based Procedure Use.The Milbank quarterly · 2022Article
- Health Care Leaders' Perspectives on the Maryland All-Payer Model.JAMA health forum · 2022Article
- What Promotes Medical Overuse: Perspective on Evolutionary Game between Administration and Medical Institutions.Computational and mathematical methods in medicine · 2022Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundMedical overuse is a leading contributor to the high cost of the US health care system and is a definitive misuse of resources. Elimination of overuse could improve health care efficiency. In 2014, the State of Maryland placed the majority of its hospitals under an all-payer, annual, global budget for inpatient and outpatient hospital services. This program aims to control hospital use and spending.
objectiveTo assess whether the Maryland global budget program was associated with a reduction in the broad overuse of health care services.
methodsWe conducted a retrospective analysis of deidentified claims for 18-64 year old adults from the IBM MarketScan® Commercial Claims and Encounters Database. We matched 2 Maryland Metropolitan Statistical Areas (MSAs) to 6 out-of-state comparison MSAs. In a difference-in-differences analysis, we compared changes in systemic overuse in Maryland vs the comparison MSAs before (2011-2013) and after implementation (2014-2015) of the global budget program. Systemic overuse was measured using a semiannual Johns Hopkins Overuse Index.
resultsGlobal budgets were not associated with a reduction in systemic overuse. Over the first 1.5 years of the program, we estimated a nonsignificant differential change of -0.002 points (95%CI, -0.372 to 0.369; p = 0.993) relative to the comparison group. This result was robust to multiple model assumptions and sensitivity analyses.
conclusionsWe did not find evidence that Maryland hospitals met their revenue targets by reducing systemic overuse. Global budgets alone may be too blunt of an instrument to selectively reduce low-value care.
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