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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


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)”.


President Ends Cost-Sharing Reduction Payments, Signs Executive Order on ACA

October 13, 2017

President Trump Oct. 12 announced his administration would stop paying cost-sharing reduction (CSR) payments effectively immediately.


MedPAC Discusses MIPS, Telehealth, and Medicare’s Hospital Value Incentive Programs

October 6, 2017

The Medicare Payment Advisory Commission (MedPAC) Oct 5-6 met to discuss a wide variety of Medicare issues, including next steps for the Merit-based Incentive Payment System (MIPS), reports on telehealth in the commercial insurance space, and Medicare’s hospital value incentive programs.


CMS Withdraws Proposed Part B Drug Payment Rule

October 6, 2017

The Centers for Medicare and Medicaid Services (CMS) Oct. 4 withdrew a rule proposed by the previous administration regarding the Medicare Program Part B Drug Payment Model, which was designed to test whether alternative drug payment designs would lead to a reduction in Medicare expenditures while preserving or enhancing the quality of care provided to Medicare beneficiaries.


Senate Unanimously Passes CHRONIC Care Act

September 29, 2017

The Senate Sept. 26 unanimously passed S. 870, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017.


On Government Affairs



Testimony and Correspondence





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