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Current Issues

Issue Updates


SHM Joins Statement Opposing Texas Legislation that Endangers the Patient-Physician Relationship

SHM joins a statement to express our deep concerns about the consequences of recently passed Texas state abortion law that impedes long-established boundaries of patient-physician relationships and medical decision-making. Read Now

Policy Update: Cuts to Hospitalist Medicare Reimbursement in 2021

CMS has finalized E/M payment adjustments that will lead to an approximate 8% decrease in Medicare Fee for Service Revenue for hospitalists. Learn more about the issue -- and about how SHM is fighting against these changes! Read Now

Policy Update: X-Waiver

The Department of Health and Human Services (HHS) has halted plans to expand access to buprenorphine and eliminate the X-waiver. 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 Submits Comments on the 2022 Outpatient Prospective Payment Systems Proposed Rule

SHM submitted comments on the Hospital Outpatient Prospective Payment System proposed rule. Read Letter

SHM Submits Comments on the 2022 Physician Fee Schedule Proposed Rule

SHM has submitted comments on the Physician Fee Schedule Proposed Rule. SHM commented on various proposals, including but not limited to, the impending budget cuts, telehealth proposals, and the Quality Payment Program. Read Letter

SHM Sends Letter on Impending Medicare Physician Payment Cuts

SHM sent a letter to Congressional leadership, urging Congress to mitigate the impending 10% payment cuts to Medicare physician payments. 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