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Current Issues

Issue Updates


SHM Endorsed ACP Position Paper Calling for a Reduction of Firearm Injuries and Death

SHM has joined dozens of other organizations in endorsing ACP's position paper "Reducing Firearm Injuries and Deaths in the United States." The paper calls for recommendations like increased research on firearm injury and death and comprehensive background checks for firearm purchases. Read paper on Annals of Internal Medicine

SHM Position on Buprenorphine Deregulation

Buprenorphine is currently a Schedule III controlled substance but has restrictions placed upon its use for this indication. We believe ... Read full statement



SHM Sends Letter to the Administration and Congressional Leaders Regarding COVID-19 Policy Changes

SHM sent a letter to the Administration, as well as to Congressional leaders, urging them to take additional actions regarding the COVID-19 pandemic...Read letter

SHM Joins Multi-Stakeholder Letter on Surprise Billing to Congress

SHM, alongside other stakeholders, sent a letter to Congress about surprise billing. We support legislative solutions that protect patients from unexpected medical bills ... 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The Medicare Access and CHIP Reauthorization Act (MACRA), passed in 2015, repealed the Medicare sustainable growth rate (SGR) formula and instituted significant reforms to the Medicare physician payment system.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.

MACRA Resources

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).

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MACRA and the Quality Payment Program | Frequently Asked Questions (FAQs): Learn about MACRA’s Quality Payment Program and its two pathways for physician payments.

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Observation Resources

Understanding Observation Care Video: With the passage of the NOTICE Act and the new MOON document for observation patients, SHM created a video resource to help with those tough conversations.

Watch Video

NOTICE Act Resources

NOTICE Act FAQs: This FAQ document explains the requirements for notifying patients under observation.

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