Maine’s health care institutions, like those around the nation, have made many changes in the past several decades to adapt to the shifting health care environment. Service models have switched emphasis from inpatient to outpatient, with many hospitals building and staffing new types of outpatient facilities. Inpatients are sicker and lengths of stay are shorter, with declining reimbursement. Technological advances continue at an ever-increasing pace, with institutions needing to stay ahead of the curve to remain competitive in the market and deliver safe and effective patient care.