Medicolegal Issues

Update from the Public Policy Committee


The Public Policy Committee has spent a great deal of time in recent months learning about the current reimbursement issues facing hospitalists. It is our belief that hospitalists bring something unique to the bedside that is not being recognized by our current payor system. This recognition will be a long-term project for the committee, but we have a number of short-term goals. The short-term goals are to educate our membership about using the currently available codes to optimize their practice; working with payors or intermediaries; and negotiating with the facilities to receive remuneration. We will investigate the possibility of coordinating with pilot projects being conducted by the Center for Medicare and Medicaid Services. These pilots may be able to demonstrate further the value of having a hospitalist manage the care of the hospitalized patient. We monitor closely any proposed changes in the Medicare fee schedule and work to preserve the current schedule as much as possible. However, longer term, we need to identify and design a model that rewards hospitalists for the quality and efficiency that they bring to their patients and facilities.

This may involve working with a number of other organizations as our allies. To this end, the Public Policy Committee recommended, and the SHM Board approved, that SHM’s government affairs contractor, Medical Advocacy Services, Inc. (MASI), draft a White Paper regarding the consideration of hospitalists as a specialty. Organizations draft such papers to thoroughly examine a particular topic. White Papers are typically used as an advocacy tool and can be presented to other organizations and to policymakers to make the case for a policy. The committee will work with MASI during the writing process, and a final paper will be released in 2005.

The Public Policy Committee also recently updated SHM’s “Guiding Principles,” which outline SHM’s position on numerous current health policy issues. The principles were first drafted by MASI and the Public Policy Committee in 2003. They enable MASI and me to make quick decisions on whether or not to sign SHM onto joint letters to Congress or the Administration. They cover areas such as medical liability, regulatory relief, and access to care. The principles will be particularly useful as health issues arise when the 109th Congress convenes in January. The updated Guiding Principles, approved by the Board in October, can be viewed on the SHM Advocacy Web site, under “Where We Stand.” We will update them regularly to address emerging and evolving issue areas.

For more information about SHM’s public policy positions, please visit the Advocacy section of the SHM Web site at

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