Skip to content

Welcome to Society of Hospital Medicine

Your Browser Is No Longer Supported. Please upgrade your browser from Internet Explorer 10 to Internet Explorer 11 or higher

Current Issues

Issue Updates


SHM Joins CMSS Statement in Support of Osteopathic Physicians

In light of recent comments disregarding the legitimacy and training of osteopathic physicians, SHM joined the CMSS statement support of osteopathic physicians.  Read Now

Why We #MaskUp

As frontline clinicians, hospitalists have been instrumental in the fight against the COVID-19 pandemic. As hospitalists continue to work each day to care for their patients, we recognize that each one of us has a responsibility to help slow the spread of COVID-19. Read Now



SHM Sends Letter Regarding Budget Neutrality in the Physician Fee Schedule Proposed Rule

SHM sent a letter to members of the Senate Finance Committee, the House Ways and Means Committee, and the House Energy and Commerce Committee regarding proposed payment adjustments and budget neutrality in the Physician Fee Schedule proposed rule. Read letter

SHM sends a Letter to Senate Majority Leader Urging Inclusion of the Immigration Reform in COVID Package

SHM sent a letter to Senate Majority Leader McConnell urging the inclusion of the Healthcare Workforce Resilience Act in the latest coronavirus relief package. Read letter

View more letters.

Observation Care

Observation is an outpatient designation originally intended to give providers time to decide whether a patient should be admitted to the hospital as an inpatient or discharged back to the community. Policies for observation care and the inpatient admission decision put significant pressure on hospitalists and their patients. Hospitalists are the key players providing observation care in hospitals and see firsthand the challenges and frustrations the policies cause.

Learn more

SHM's Observation White Paper Calls for Elimination of Observation

SHM is calling for major reform to observation care policies to streamline care. Download the white paper to read perspectives from frontline hospitalists and recommendations from SHM that aim to streamline care, reduce administrative burden and protect patients from unpredictable, out-of-pocket costs.

Download white paper


The Medicare Access and CHIP Reauthorization Act (MACRA), passed in 2015, repealed the Medicare sustainable growth rate (SGR) formula and instituted significant reforms to the Medicare physician payment system. MACRA created the Medicare Quality Payment Program (QPP) with the goal of moving away from fee-for-service payments and into more value-based payments.  

The QPP has two pathways for physician payment:

  • The Merit-Based Incentive Payment System (MIPS) combines PQRS, physician value-based payment and Meaningful Use into one streamlined system. Providers in this pathway will receive Medicare Part B payment adjustments based around performance in the MIPS.
  • Alternate payment models (APMs) exempt providers from the MIPS and give a 5% Medicare payments bonus. APMs move farther away from fee-for-service Medicare and include models accountable care organizations (ACOs) and patient-centered medical homes (PCMHs).

Visit SHM's MACRA resource page to learn more about the QPP and how to participate.

Other Topics

SHM works on an array of other policy issues that impact hospitalists and their patients.

Recent efforts include:

  • Encouraging Congress to support advance care planning by incentivizing patients to create advance directives. Read our letter to Congress.
  • Advocating to the Centers for Medicare and Medicaid Services (CMS) for changes to the evaluation and management (E/M) documentation requirements. Read our letter to CMS.
  • Submitting ideas for relief from administrative and regulatory burdens to the federal administration, including asking for changes to observation, relief from PQRS penalties and addressing issues with MACRA alternative payment models. Read our letters to the House Ways and Means Committee.

Policy Resources

SHM offers hospital medicine professionals a wide variety of resources to navigate the ever-changing policy landscape.

MIPS Guide for Hospitalists

Understanding the Merit-based Incentive Payment System, as part of the Quality Payment Program. What does it mean for you? Learn how to report measures and participate in the Merit-based Incentive Payment System (MIPS).

Download Now

MACRA and the Quality Payment Program | Frequently Asked Questions (FAQs)

Learn about MACRA’s Quality Payment Program and its two pathways for physician payments.

Download Now


This FAQ document explains the requirements for notifying patients under observation.

Download Now