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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


MedPAC Releases March 2017 Report to Congress, Recommends Annual Medicare Payment Adjustments

March 17, 2017

The Medicare Payment Advisory Commission (MedPAC) March 15 released its March 2017 Report to Congress, which includes recommended annual adjustments for Medicare’s various payment systems.


CMS Posts FAQs for the Medicare Outpatient Observation Notice to Website

March 17, 2017

The Centers for Medicare and Medicaid Services (CMS) March 8 posted frequently asked questions (FAQs) for the Medicare Outpatient Observation Notice (MOON) to its website.


MedPAC Discusses MACRA and Medicare Part B Payment Policy

March 3, 2017

The Medicare Payment Advisory Commission (MedPAC) Mar. 2-3 met to discuss a range of Medicare issues, including Medicare Part B payment policy issues, approaches to MACRA implementation, and establishing a prospective payment system for post-acute care.


Senate Finance Committee Advances CMS Administrator to Full Senate

March 3, 2017

The Senate Finance Committee March 2 voted 13-12 along party lines to advance Centers for Medicare and Medicaid Services (CMS) Administrator nominee Seema Verma to the full Senate for consideration.


President Trump Focuses on Health Care and Immigration in Address to Congress

March 3, 2017

President Trump Feb. 28 delivered his first address to a joint session of Congress. During his speech, the president outlined a number of policies of importance to medical schools and teaching hospitals, including health care, immigration, and budget priorities.


On Government Affairs



Testimony and Correspondence





External Resources