US healthcare spending is maddeningly high. As in: fifty percent higher than what other wealthy countries spend, with no evidence we’re getting any bang for all those additional healthcare bucks.
In 2014, the state of Maryland took direct aim at this profitless profligacy, enacting a bold (dare I say European?) approach : it gave hospitals fixed budgets to cover the costs not only of inpatient hospital care, but also outpatient care and emergency room services. It basically told hospitals that, if they wanted to stay in business, they better figure out how to care for patients more efficiently.