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GBR in Maryland – A new payment methodology for Maryland hospitals

Recently, you may have heard the acronym “GBR” being tossed around in meetings and hallways of the hospital. “GBR” has been called a tectonic shift in the decades-old Maryland all-payer model. So what is GBR, and why is it so important?

GBR (Global Budget Revenue) is a payment method recently implemented by Maryland’s all-payer system (regulated by the HSCRC) in conjunction with the new Medicare waiver program. GBR restricts the amount of revenue a hospital (or system) can generate by capping the annual revenue budget.  Hospitals are guaranteed the authority to charge up to the annual cap, but may not exceed it. This is regardless of volumes.

Some important points about GBR:

  • A major goal of GBR is to emphasize quality and cost control and de-emphasize volume and growth.
  • 95% of Maryland hospital revenue is currently under a global budget (exceptions are out of state revenues for hospitals with a large percentage of business from non-Maryland patients)
  • One major concern is the potential impact on the ability for hospitals to invest in the technologies, infrastructure and capital (both human and physical) that would be necessary to fully transform current healthcare delivery models into value-based systems
  • The GBR for JHH is currently $1.75 billion and for Bayview is $584 million

The School of Public Health has just announced a five-part webinar series on GBR and its impact. If you are interested in learning more, go to

-Doug Brooks, Director of Finance


Kelsey Bennett