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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


Senate Finance Committee Holds CMS Administrator Confirmation Hearing

February 17, 2017

The Senate Finance Committee Feb. 16 held a confirmation hearing for President Trump’s Centers for Medicare and Medicaid (CMS) Administrator nominee, Seema Verma.


CMS Announces Awardees of Resident Cap Increases Under Residency Slot Redistribution Program

February 3, 2017

The Centers for Medicare and Medicaid Services (CMS) Jan 31 released three rounds of awardees of resident cap increases through the closed hospital residency slot redistribution program under Section 5506 of the Affordable Care Act (ACA, P.L. 111-148 and P.L. 111-152). 


House Energy and Commerce Committee Holds Medicaid Hearings

February 3, 2017

As part of Affordable Care Act (ACA) repeal and replace and Medicaid reform debates on Capitol Hill, two House Energy and Commerce Subcommittees held hearings focused on oversight and strengthening the Medicaid program.


Senate and House Committees Hold Hearings on Insurance Exchanges

February 3, 2017

The Senate HELP Committee Feb. 1 held a hearing on the stability of the individual insurance market. Witnesses included members representing America's Health Insurance Plans, the National Association of Health Underwriters and the National Association of Insurance Commissioners, and former Kentucky Governor Steven Beshear.


CMS Posts Updated Instructions to Medicare Outpatient Observation Notice

January 27, 2017

The Centers for Medicare and Medicaid Services (CMS) Jan. 20 posted updated instructions for the Medicare Outpatient Observation Notice (MOON). 


On Government Affairs



Testimony and Correspondence





External Resources