health care reform

Frequently Asked Questions

Will GBMC move to an all-employed model for physicians?

GBMC does not intend to move to an all-employed physician staff model. We recognize that many community-based physicians desire independence, and we will not exclude them from our alliance. In fact, the community providers will play an important role as we move forward, that is why we have formed a new entity known as the Greater Baltimore Health Alliance.
What is the Greater Baltimore Health Alliance?

Over the past several months you have been hearing a lot about changes in healthcare delivery in the United States, in our community and here at GBMC. Much is still unknown as the Federal Health Reforms are finalized, however we believe that change is imminent with an unsustainable economic model for health care in the U.S. The information presented on this document may be helpful for you to understand how GBMC is moving forward with our employed and communitybased health providers.

As part of GBMC Healthcare, the Greater Baltimore Health Alliance is chartered to integrate the delivery of the full spectrum of clinical services through collaboration of employed and community-based physicians and the hospital with the goal of improving access for patients and providers, maximizing quality and reducing the cost of care. The alliance will use data collected through electronic medical records to help facilitate coordination of care, and allow providers to make decisions based on real-time quality and cost information.
Am I required to implement an Electronic Medical Record system in my practice?

Lack of an EMR makes it difficult for providers to share patient information among other caregivers. Providers who choose to participate in the Greater Baltimore Health Alliance will be required to have a certified EMR. Although it is not currently required by law, the government is incenting providers to implement and use an EMR in their practice (meaningful use). These dollars are available to help offset the cost of acquiring the Information Technology systems. Additionally, there are implications in terms of reduced reimbursement from the federal government if you are not using a system by 2015.
Can GBMC help me get an EMR?

GBMC is one of three hospitals in Maryland currently pursuing certification as a Management Services Organization (MSO). As such, we will be able to provide practice management assistance, workflow redesign and EMR selection services. GBMC is partnering with E-ClinicalWorks to implement Practice Management and EMR systems in the GBMA practices, and we will begin to enroll aligned community based physicians in our MSO, through Greater Baltimore Health Alliance, in the coming year.
Is GBMC focusing only on Primary Care Physicians?

No, it will be vital to have physicians of all specialties participate. Although it is clear that many of the initiatives in healthcare reform emphasize the importance of primary care, our patient population is aging and will need care that can only be provided by specialists. Our goal is to create an alliance that meets the needs of the patient, be it wellness and prevention or acute episodic care, which ultimately may evolve into an Accountable Care Organization.

What is an Accountable Care Organization?

The National Institute for Quality Assurance (NCQA) defines Accountable Care Organizations as, provider-based organizations that take responsibility for meeting the health care needs of a defined population with the goal of simultaneously improving health, improving patient experience and reducing per capita costs. We may evolve into an ACO, but that is not our immediate intent. We will, however, use the principles of an Accountable Care Organization to assure that we focus on maximizing quality and removing waste from the system. Becoming an Accountable Care Organization is a means to an end, it is not the end itself.
How is an ACO different from HMOs and Managed Care of the 1990s?

In the 1990s, several organizations (Doctors Health, MPPI, Premier etc.) were formed by Hospitals or Venture Capital firms in order to market Medicare and Commercial risk products to the general public to capture market share and/or make a substantial bottom line. We all recognize the folly in this business model as there was no mandate to substantiate that strategy from the Government or third party insurers. The difference now is that the Government and Care First are moving forward with initiatives designed to reduce cost and improve quality while holding risk for the premium dollar rather than shifting that risk to the provider.
Will GBMC participate in any of the Commercial or Government payer incentive programs?

Yes. Our employed physicians will participate in the Blue Cross Medical Home program beginning in January of 2011 along with many of our community based physicians. Additionally, GBMC intends to enroll in the Medicare Shared Savings Program expected to begin in January of 2012. It is possible that commercial payers will announce additional programs in the coming years as well. If so, GBMC will evaluate the benefit of each program and make a determination about participation. Many of the incentive programs commence in calendar year 2011. The government programs ramp up over the next few years, transitioning from incentive in 2012 to penalty in 2015.
Does GBMC need to be part of a larger Health System to navigate Healthcare Reform?

We believe strongly that we can continue to remain independent in the new healthcare environment. Therefore, we are not proactively seeking to acquire or be acquired. As with all Accountable Care Organizations, new partnerships may be required to help us ensure that we are able to fulfill the patients needs in the continuum of care. We will evaluate these opportunities as they present themselves.
If you would like additional information, clarification, or further detail regarding healthcare reform and its impact on GBMC, please dont hesitate to contact

Colin Ward Executive Director of Greater Baltimore Health Alliance (443) 849-2331 cward@gbmc.org.