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Md. hospitals look for easier way to modify facilities
As Maryland hospitals work to reduce admissions by improving the overall health of their communities, officials expect they’ll need fewer inpatient beds and more outpatient facilities.
But the Maryland Hospital Association says current law doesn’t give hospitals the flexibility they need to modify facilities to accommodate that new focus. So the organization is calling for a change.
“What we’re seeking is a process that allows hospitals to be nimble in changing physical space,” said David Simon, spokesman for the hospital association. Hospitals are no longer looking to increase the volume of patients they treat, but to get more care into the community, he said.
Currently, hospitals and health systems must obtain a certificate of need from the Maryland Health Care Commission if they want to change the bed capacity of a facility or change the scope of services offered at the facility — a process that takes too long and “flies in the face of agile, modern health care models,” according to an issue paper put out by the hospital association.
Hospitals need to be able to establish and operate freestanding medical facilities — which would still be regulated under the rate-setting system used for hospitals — to provide outpatient care, according to the association.
“It’s important for the industry,” said Donna Jacobs, senior vice president, government and regulatory affairs, for the University of Maryland Medical System. “As we move forward, more care will be given at ambulatory centers.”
Maryland is nearly two years into an experiment in which hospitals operate on fixed annual budgets — providing a financial incentive to reduce admissions by focusing on preventive care.
Over the past 10 years, inpatient admissions at the state’s hospitals have dropped by nearly 100,000, according to the hospital association.
“What we don’t want, as citizens of Maryland, is more capacity for services we don’t need,” said Dr. John B. Chessare, president and CEO of Greater Baltimore Medical Center.
While the Certificate of Need process helped keep the state from being inundated with unneeded facilities, the process should be streamlined so hospitals that are trying to thrive aren’t bogged down, Chessare said.
GBMC, for example, uses profits from its hospital facilities to help fund its network of 12 patient-centered medical homes, which focus on comprehensive primary care to keep chronically ill patients from needing to go to the hospital, Chessare said.
Those facilities don’t usually cover their own costs, so they depend on hospital revenue, he said.
“If you take the moneymaking pieces out, you leave the community at risk,” Chessare said.
