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Hospitals Over the DGME Cap, 2010 Total Number of Hospitals Over the Cap Total Number of Resident FTEs Over the Cap 350 (65%) Other Teaching Hospitals 187 (35%) Major Teaching Hospitals 6,866 (74%) Resident FTEs 2,472 (27%) Resident FTEs Source: Medicare Cost Report, FY2010 (August 2012 Release). If they did not have an FY2010 submitted cost report, we took their FY2009 cost report, if available. Note: Hospitals with an FY 2010 are defined as hospitals with fiscal periods beginning between 10/1/2009 and 9/30/2010. Hospitals in this analysis only include PPS teaching hospitals (as determined by the IPPS Final Rule Impact File, FY2013 with an intern and resident-to-bed ratio greater than 0) with a submitted Medicare Cost Report for FY2010 and a DGME Cap and Count. These data reflect results from the resident limit redistribution programs as published at the CMS website. Data from the cost reports are “As Submitted” and may change upon audit. Major teaching hospitals are defined as having an intern and resident-to-bed ratio greater than or equal to 0.25. 2012 AAMC Annual Meeting
Resident Limit Redistributions ACA Affected Resident Caps in Two Ways: • Redistributed 65% of unused slots (Sec. 5503) • Redistributed all slots from hospitals that closed on or after 3/23/2008 (and forever into the future!) (Sec. 5506) 2012 AAMC Annual Meeting
Page 1 and 2: State of the Academic Clinical Ente
Page 3 and 4: AAMC Health Care Affairs • Suppor
Page 5 and 6: DataTrends: Hospital Margins 2012 A
Page 7 and 8: Hospital Total All-Payer Margins, b
Page 9 and 10: COTH Characteristics Short-Term, Ge
Page 11 and 12: COTH Quarterly Survey Results 2009-
Page 13: Medicare Resident Limits: Mandated
Page 17 and 18: Sec. 5506 Slots by Teaching Status
Page 19 and 20: Sec. 5506 DGME Slots by State - Fir
Page 21 and 22: 2012 AAMC Annual Meeting Readmissio
Page 23 and 24: Concern with Risk Adjustment • Ri
Page 25 and 26: Readmission Rates are Higher for Du
Page 27 and 28: Approach: Model Specification and S
Page 29 and 30: Readmission Program Impact on COTH
Page 31 and 32: Value-Based Purchasing (VBP) • Mo
Page 33 and 34: How is the VBP Money Moving? Major,
Page 35 and 36: Medicare Spending Per Beneficiary (
Page 37 and 38: Exclusions •IME and DSH payments
Page 39 and 40: MSPB National Distribution 50% Medi
Page 41 and 42: MSPB - Where Spending Occurs Breakd
Page 43 and 44: Physician Payments at HOPD For many
Page 45 and 46: MedPAC Proposal 99213 - Midlevel Es
Page 47 and 48: Study AAMC contracted with The Mora
Page 49 and 50: Distribution of Medicare E/M Visits
Page 51 and 52: Major Teaching Hospitals Serve Prop
Page 53 and 54: High Level Findings • Proposed
Page 55 and 56: What is a bundled payment? • New
Page 57 and 58: AHA-AAMC Bundling Analysis Key Ques
Page 59 and 60: Defining the Bundle Characteristics
Page 61 and 62: Pricing the Bundle Add-on payments
Page 63 and 64: Pricing the Bundle: Add-on Payments
Page 65 and 66:
Pricing the Bundle: Patient and Hos
Page 67 and 68:
Managing the Bundle: Readmissions s
Page 69 and 70:
Managing the Bundle: Percent of Rea
Page 71 and 72:
Key Findings • Bundling is here
Page 73 and 74:
Bundled Payments for Care Improveme
Page 75 and 76:
AAMC Applicant Organizations • Al
Page 77 and 78:
Brandeis Data Analysis Total allowe
Page 79 and 80:
BPCI Lessons Learned To Date • AM
Page 81:
Questions??? Additional information
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Hospitals

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