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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 teaching 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 | Coverage and Delivery Reform

News and Updates

MedPAC Issues June 2018 Report to Congress, Including Two Emergency Department Recommendations

June 22, 2018

The Medicare Payment Advisory Commission (MedPAC) June 15 released its June 2018 Report to the Congress, which considers ten issues affecting the Medicare program, including the effects of the Hospital Readmission Reductions Program (HRRP), rebalancing Medicare’s physician fee schedule toward ambulatory evaluation and management (E&M) services, and hospital emergency department (ED) services.

CMS Postpones the July 2018 Update to the Hospital Quality Star Ratings

June 15, 2018

The Centers for Medicare and Medicaid Services (CMS) June 12 announced that it is postponing the July 2018 release of updated Overall Hospital Quality Star Ratings on the Hospital Compare

Rep. Matsui Introduces Bill in Support of 340B Program

June 15, 2018

Representative Doris Matsui (D-Calif.) June 12 introduced the Stretching Entity Resources for Vulnerable (SERV) Communities Act (H.R. 6071) to support and expand the 340B Drug Pricing Program.

House and Senate Continue Work to Combat Opioid Epidemic

June 15, 2018

The House and Senate the week of June 11 continued their work on a series of bills intended to combat the opioid epidemic.

HHS Seeks Public Comment to Develop Workgroup to Increase Innovation and Investment in Healthcare Sector

June 8, 2018

The Department of Health and Human Services (HHS) June 6 released a request for information (RFI) seeking public comment on a planned initiative to develop a workgroup to focus on promoting innovation and investment to provide for significant impact on the health and wellbeing of Americans.  The Department envisions the workgroup as a forum to hear the individual perspectives of attendees and foster new and innovative approaches to tackle the complicated challenges facing the healthcare industry.

On Patient Care

Testimony and Correspondence