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Society of Hospital Medicine’s Advocacy Efforts, Then and Now

Another year older, another year wiser. SHM’s advocacy efforts have grown immensely in the last year thanks to proactive members who understand the importance of being involved and taking action. Because of member engagement—through the online Legislative Action Center and in-person meetings with members of Congress—hospitalists are widely recognized on Capitol Hill as thoughtful resources on policy issues who prioritize the improvement of patient care and the healthcare system.

This year alone, we have had a demonstrable impact on three key health policy issues: the sustainable growth rate (SGR), meaningful use, and observation status.

SGR repeal has been a consistent source of frustration and a regular feature of SHM’s advocacy efforts, including messages from hundreds of hospitalists to Congress, numerous requests for input from SHM as Congress worked on developing repeal legislation, and meetings with lawmakers to further shape legislation and to ask for the prioritization of a permanent, reliable solution. Although temporary patches have been the norm, SHM has not given up on repeal efforts and continues to push Congress to move past this failed formula.

Awareness of the precarious position of hospitalists in meaningful use has broadened significantly, and SHM worked with CMS to secure an exception from penalties for most hospitalists for 2015. The exception is only temporary, however, and SHM members will be essential in the effort to convince both CMS and Congress to enact a sensible permanent solution.

Observation status and the two-midnight rule saw significant coverage and interest throughout the year. Hospitalist and SHM Public Policy Committee member Ann Sheehy, MD, MS, FHM, testified about the impacts of observation status on hospitals and on patients in front of both the House Ways and Means Subcommittee on Health and the Senate Special Committee on Aging. The SHM Public Policy Committee also published a widely read white paper explaining SHM’s position on the issue.

Here is a key passage that perfectly reflects SHM’s position on observation status:

“Any policy change should be rooted in common sense, reflective of clinical reality, and designed to ensure that patients and providers are incentivized to work together to improve health. Patients should be able to get the care that they need, when they need it, including access to SNF [skilled nursing facility] care. Medicare policies should not be unnecessary impediments to physician judgment and workflow and should be geared toward reducing administrative burden and complexity.”1

Advocacy needs the active voices of those who understand the daily impacts of health policies. SHM would not be as successful a resource without our hospitalist members taking steps to better the healthcare system overall.

Building relationships with policymakers is the key to SHM remaining a prominent resource that is trusted and respected in Washington, D.C. At the 2015 annual meeting in National Harbor, Md., SHM will be sponsoring another “Hospitalists on the Hill” event, where we plan to build on recent successes. In 2013, more than 100 hospitalists took to the halls of Congress to advocate for pressing policy issues. Be sure to plan accordingly, as Hill Day will be an all-day event on April 1, the final day of the meeting.

Ellen Boyer is SHM’s government relations project coordinator.


  1. Society of Hospital Medicine. The observation status problem: impact and recommendations for change. Available at: Accessed November 15, 2014.

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