The number of admissions to Maryland hospitals has dropped over the past several years. For the FY ending June 2011, admissions at WMHS were down about 5%, which mirrors the state average. Part of the admissions decline is in response to payment reform in Maryland, but the other part can be attributable to the efforts to improve the health care delivery system. We have been working to ensure that the most appropriate care is being delivered in the most appropriate setting. Routinely, patients who needed care and treatment beyond the Emergency Department were often admitted to the hospital; now they may receive care in our Observation Unit or discharged and followed up at home or in one of our clinics. Lots of changes are happening as we try to stay on the forefront of care being delivered in a different way. Stay tuned.