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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 to CMS to Delay Episode Payment Models

April 21, 2017

The AAMC April 19 submitted a comment letter to the Centers for Medicare and Medicaid Services (CMS) regarding the delay of Episode Payment Models (EPMs) under the interim final rule with comment period.


CMS Releases FY 2018 IPPS Proposed Rule and Request for Information

April 21, 2017

The Centers for Medicare and Medicaid Services (CMS) April 14 released the Inpatient Prospective Payment System (IPPS) proposed rule containing changes to Medicare payment policies and rates under the IPPS and the Prospective Payment System (PPS) payment update for fiscal year (FY) 2018.


MedPAC Passes Medicare Part B Drug Pricing Recommendations

April 7, 2017

The Medicare Payment Advisory Commission (MedPAC) April 6 passed several recommendations to change Medicare Part B drug payment policy. The commission also discussed a variety of other Medicare payment issues, including converting Medicare fee-for-service (FFS) to a premium support program. 


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.


On Government Affairs



Testimony and Correspondence





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