UMMS looks to trauma, acute care for near future

By Aaron Cahall
Examiner Staff Writer 8/27/08

As primary care doctors become increasingly scarce and with trauma care reimbursement surpassing that of some other services, one hospital system may be taking the safe bet.

The University of Maryland Medical System said this week it will favor acute care and Shock Trauma projects in the near future, after abandoning a $350 million outpatient care center earlier this month.

A report earlier this month by the National Association of Community Health Centers found a shortage of basic primary care physicians around the country. The discipline often pays doctors and hospitals back less than other specialties, which hospital watchers speculated may have been behind UMMS’ change in priorities.

“This may be another manifestation of that,” said Stephen Johnson, interim executive director of the Maryland State Medical Society, also known as MedChi.

The medical system on Aug. 18 withdrew plans with state regulators to build a $350 million ambulatory care center at its downtown Baltimore campus. In a statement to The Examiner this week, spokeswoman Joan Shnipper said, “For a variety of reasons including land acquisition, the [ambulatory care center] developed more slowly than expected. Now we forecast a more immediate need for Shock Trauma expansion, emergency services and acute bed capacity.”

Shnipper and UMMS officials did not return subsequent calls for comment Wednesday.

Johnson said that outpatient reimbursement is worked out with individual insurance providers. But he added the Maryland Health Services Cost Review Commission regulates inpatient service costs.

“They’re structured to provide a certain rate of return,” Johnson said. “Where outpatient doesn’t have that ... your reimbursement is based on what CareFirst [and others] will give you.”

Other physicians said they’ve seen a general shift in hospitals’ interest toward lucrative inpatient and trauma services but could not say whether that was a factor in UMMS’ move.

“More of the hospitals are going to where the money is, rather than where the need is,” said Dr. Ron Sroka, a longtime family practitioner in Crofton and president-elect of MedChi. “That’s probably what’s happening here, though I can’t say with any degree of certainty at this point.”

acahall@baltimoreexaminer.com

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