Public Policy

New Bill Hopes to Increase Residency Medicare Slots after Two Previous Bills Failed

The new version again seeks to increase Medicare residency slots by 15,000 over five years, while attempting to identify physician shortage specialties and increase the workforce diversity. Two federal bills introduced in 2013, the Resident Physician Shortage Reduction Act and the Training Tomorrow’s Doctors Today Act, would have increased the number of Medicare-funded residency slots… [Read More]

10 Tips for Hospitalists to Achieve an Effective Medical Consult

Institute of Medicine Report Prompts Debate Over Graduate Medical Education Funding, Oversight

Ever since 1997, when the federal Balanced Budget Act froze Medicare’s overall funding for graduate medical education, debates have flared regularly over whether and how the U.S. government should support medical resident training. Discussions about the possible redistribution of billions of dollars are bound to make people nervous, but the controversy reached a fever pitch… [Read More]

The Difficulty of Predicting Physician Shortages

Much of the criticism directed at the IOM’s proposed revamping of federal GME funding stems from the idea that a graying population will place additional strains on a healthcare system that already is facing a significant doctor shortage. “Number one, they came out and said, ‘We don’t know that there’s a shortage of physicians and… [Read More]

Experts Urge Extension to Medicaid’s Parity Program

On the last day of 2014, a provision of the Affordable Care Act (ACA) that increased payments to some physicians providing primary care services to the country’s poorest patients expired. The Medicaid payment parity program, under section 1202 of the ACA, increased to Medicare levels Medicaid reimbursement for primary care services rendered by internists, pediatricians,… [Read More]


CMS Proposes Changes to Two-Midnight Rule

On July 1, 2015, the Centers for Medicare and Medicaid Services (CMS) announced proposed changes to its controversial two-midnight rule. The changes afford physicians more flexibility to determine patient hospitalization status and place primary patient status auditing authority with Quality Improvement Organizations (QIO), rather than the unpopular Recovery Auditor Contractors (RACs). The original policy was… [Read More]

Medicare Initiatives Improve Hospital Care, Patient Safety

As a hospitalist myself, I have seen firsthand the need for a healthcare system that provides better care, spends dollars more wisely, and keeps people healthier. I practice on weekends taking care of children, many of whom have multiple chronic conditions and fragile social support, and their families. I love patient care; however, too many… [Read More]

ICD-10 Medical Coding System Likely to Improve Documentation, Reimbursement

ICD-10 is the system that will replace ICD-9 for all parties covered by the Health Insurance Portability and Accountability Act (HIPAA). ICD-10 contains a code set used for inpatient procedural reporting and a code set used for diagnosis reporting. Physicians billing for professional services will only be affected when reporting diagnoses codes on their claims,… [Read More]

Medicare Rankings Favor Small, For-Profit Hospitals

In April, the Centers for Medicare and Medicaid Services (CMS) publicly revealed for the first time which hospitals achieved five stars and which had room for improvement based on patient experience per the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Although these measures are not new, this year CMS assembled the star… [Read More]

SGR Repeal: What It Means for Hospitalists

On April 16, President Obama signed into law a bipartisan, bicameral piece of legislation that not only fully repealed the sustainable growth rate (SGR) but also permanently eliminated the recurring threat of physician payment cuts in Medicare. Along with the SGR repeal, the Medicare Access and CHIP Reauthorization Act, or MACRA, institutes the Merit-based Incentive… [Read More]