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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.

Medicare

GME | Hospital Quality and Payment | Physician Quality and Payment

The Medicare program, run by the Centers for Medicare and Medicaid Services (CMS), provides health insurance to the aged, disabled, and individuals who have end stage renal disease (ESRD).  Medicare, however, also plays a special role funding Graduate Medical Education (GME) at teaching hospitals. 

Medicare Disproportionate Share (DSH) payments compensate certain hospitals for the higher operating costs they incur in treating a large share of low-income patients, which teaching hospitals do. These hospitals often face substantial financial pressure, as they may provide significant amounts of care to the poor and lack the revenue needed to underwrite the costs associated with the provision of services.

Other areas of Medicare of interest to teaching hospitals and physicians include:

  • the Inpatient Prospective Payment System (IPPS) and Outpatient Prospective Payment System (OPPS);
  • the Medicare Physician Fee Schedule (PFS);
  • the Center for Medicare and Medicaid Innovation (CMMI); and
  • the Medicare Payment Advisory Commission (MedPAC).

Payments: DSH | Geographic Variations | HIT | Coverage and Delivery Reform


News and Updates


CMS Finalizes Changes to the Quality Payment Program for 2018

November 3, 2017

The Centers for Medicare and Medicaid Services (CMS) Nov. 2 released a final rule that will make changes to the Quality Payment Program under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA, P.L. 114-10) for 2018.


CMS Issues Final Physician Fee Schedule Rule for 2018

November 3, 2017

The Centers for Medicare and Medicaid Services (CMS) Nov. 2 issued the Physician Fee Schedule (PFS) final rule, which would update payment rates and policies for services provided by physicians and other clinicians to Medicare beneficiaries in 2018.


CMS Issues CY 2018 OPPS Final Rule

November 3, 2017

The Centers for Medicare and Medicaid Services (CMS) Nov. 1 issued the Outpatient Prospective Payment System (OPPS) final rule with comment for calendar year (CY) 2018.


House Plans to Vote on Extension of CHIP, Other Extenders

November 3, 2017

The House of Representatives Nov. 3 passed legislation (H.R. 3922) by a vote of 242 to 174 that will extend the Children’s Health Insurance Program (CHIP), community health center funding, and several other Medicare extenders.


AAMC Submits Comment Letter on Proposed Cancellation of Episode Payment Models and Changes to the Comprehensive Care for Joint Replacement Model

October 13, 2017

The AAMC Oct. 12 submitted a comment letter to the Centers of Medicare and Medicaid Services (CMS) regarding the cancellation of Episode Payment Models (EPMs) under the proposed rule entitled, “Medicare Program; Cancellation of Advancing Care Coordination through Episode Payment and Cardiac Rehabilitation Incentive Payment Models; Changes to Comprehensive Care for Joint Replacement Payment Model (CJR)”.


On Government Affairs



Testimony and Correspondence





External Resources