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Second Opinion

Learn about policy issues important to medical schools and teaching hospitals, with Executive Vice President Atul Grover, M.D., Ph.D.


Coverage and Delivery Reform | HIT

Medicaid is a joint federal and state safety net program that assists over 60 million low-income individuals in receiving access to clinician offices, acute and long term care services. Teaching hospitals treat a disproportionate share of Medicaid patients, with approximately 28% of all Medicaid discharges coming from COTH hospitals.

Medicaid also plays a critical role in funding graduate medical education. State and local governments, through their Medicaid programs, appropriate approximately $5 billion for medical school training annually. Most states choose to allocate a portion of their Medicaid budget to fund direct graduate medical education (DGME), indirect medical education (IME), and other special services related to teaching hospitals. Due to state budget shortfalls and the prevalence of Medicaid managed care organizations, there are serious concerns that fewer Medicaid funds will be available to train future physicians.

News and Updates

CMS Releases Proposed Rule on Annual Reduction to State Medicaid DSH Allotments

July 28, 2017

The Centers for Medicare and Medicaid Services (CMS) July 27 released a proposed rule that delineates the methodology to implement annual reductions to state Medicaid Disproportionate Share Hospital (DSH) allotments, beginning in fiscal year (FY) 2018 and ending in FY 2025.  

AAMC Opposes CMS’ July 13 Proposed Rule to Dramatically Reduce Medicare Outpatient Drug Reimbursement for “340B” Hospitals

July 14, 2017

The Centers for Medicare and Medicaid (CMS) July 13 released the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment system proposed rule for Calendar Year (CY) 2018, which includes a major reduction in Medicare outpatient drug payments for “340B” hospitals.  AAMC strongly opposes this proposed payment reduction, as does the American Hospital Association and other hospital organizations. 

CBO Releases Estimates of BCRA Coverage and Cost; Senate Delays Vote

June 30, 2017

The Congressional Budget Office (CBO) June 26 released an estimate of the Senate’s health care bill, the Better Care Reconciliation Act of 2017 (BCRA), which would dramatically restructure Medicaid financing, modify the premium subsidies, and eliminate enhanced federal funding for Medicaid expansion over a three year period, among other provisions [see Washington Highlights, June 23].

AAMC Opposes Senate Health Care Reform Bill

June 23, 2017

The Senate June 22 released a discussion draft of its health care reform bill, the Better Care Reconciliation Act of 2017 (BCRA). The bill would dramatically restructure Medicaid financing, modify the premium tax credits, and loosen 1332 waiver requirements, among other provisions.

MACPAC Releases June Report to Congress

June 16, 2017

The Medicaid and CHIP Payment Advisory Commission (MACPAC) June 15 released its June 2017 Report to Congress, which includes an analysis of mandatory and optional enrollees and services in Medicaid, how state Medicaid programs are responding to the opioid epidemic, and an examination of program integrity activities in Medicaid managed care.

On Government Affairs

Testimony and Correspondence

External Resources