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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


HHS OIG Releases Updated Work Plan

June 16, 2017

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) June 15 released its updated work plan, which sets forth several different projects – including OIG audits and evaluations that are underway or planned – to be addressed during the fiscal year and beyond by OIG’s Office of Audit Services and Office of Evaluation and Inspections. The work plan was last published November 2016.


AAMC Submits Comment Letter on IPPS FY 2018 Proposed Rule

June 16, 2017

The AAMC June 13 submitted a comment letter on the Centers for Medicare and Medicaid Services (CMS) Inpatient Prospective Payment System (IPPS) fiscal year (FY) 2018 proposed rule.


Bipartisan GME Legislation Reintroduced in Senate

June 9, 2017

Senators Bill Nelson (D-Fla.), Dean Heller (R-Nev.) and Democratic Leader Chuck Schumer (D-N.Y.) June 7 introduced the Resident Physician Reduction Act of 2017 (S. 1301), a companion bill to the House bill (HR 2267), which was filed May 1 by Representatives Joe Crowley (D-N.Y.) and Ryan Costello (R-Pa.) [see Washington Highlights, May 5].


AAMC Commends Senate Finance Committee on Chronic Care Bill

May 19, 2017

The Senate Finance Committee May 18 approved, 26-0, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 (S. 870).


House Passes American Health Care Act

May 5, 2017

The House May 4, 217 to 213, passed the American Health Care Act (AHCA, H.R. 1628), legislation that repeals significant portions of the Affordable Care Act (ACA, P.L. 111-148 and P.L. 111-152) and changes the Medicaid financing structure [see Washington Highlights, March 10 and April 28].


On Government Affairs



Testimony and Correspondence





External Resources