Dr. Howell
As we begin a new year, it’s common to set goals and identify areas for improvement—both in our personal and professional lives.
In 2023, SHM released its inaugural Annual Report outlining the Society’s progress towards the four strategic goals recently established by the Board of Directors:
- Invest in a diverse, equitable, and inclusive culture.
- Strengthen the SHM community as a place to belong, grow, and partner.
- Advocate for the members and the field of hospital medicine.
- Advance health care delivery, quality, and experience through science and innovation.
In previous issues of The Hospitalist, we have talked about our accomplishments throughout the year and emphasized SHM’s commitment to promoting diversity, equity, and inclusion (see the June, September, and November 2023 issues). We have also aimed to build the SHM community (see the July issue for Converge coverage and SIG and chapter spotlights in nearly every issue).
In this article, I wanted to highlight our goals specific to advocating for you and the field of hospital medicine, and our efforts to advance our field through scientific research and innovation as we enter into a new year together.
SHM Goal: Advocate for the members and the field of hospital medicine
SHM has been actively advocating for hospitalists and their patients and has achieved several significant wins in 2023.
One of the most notable victories was on the split/shared billing issue. The SHM advocacy department, along with the Public Policy Committee, worked tirelessly to ensure that medical decision making could still be used to determine who performed the “substative portion” of the visit.
The Centers for Medicare and Medicaid Services (CMS) had proposed that only time could be used for split or shared visits, which would have made it difficult for hospitals and physicians to bill accurately. Thanks to SHM’s efforts, routine inpatient bills can now be either time-based or based on medical decision making. It’s important to recognize that wins like this, where a potential hardship is averted, can be overlooked, but SHM acted quickly and effectively to prevent it from happening.
The split/shared billing victory is only one of many examples of our work and impact in 2023.
SHM successfully nominated two members to serve on committees for the new partnership for quality measurement, which reviews and provides recommendations on quality measures used by CMS.
We also organized Hill Day 2023, where members from the Public Policy Committee and chapters visited more than 43 congressional offices (read article here). As the year came to a close, we worked hard to raise the awareness of the payment cuts, which go into effect in 2024. We will continue to advocate to stop these cuts this year.
We made progress on many of our policy priorities, including reauthorizing the Conrad 30 program, reforming prior authorization, and protecting the hospital medicine and broader health care workforce.
At SHM, it has never been just about the money. Our advocacy has been focused on our patients, too. For example, under the leadership of Dr. Ann Sheehy, SHM has started to reengage on the observation issue. Our goal is to ensure that every day spent in the hospital, whether admitted or as observation, counts towards the three-day stay requirement for skilled nursing facility coverage.
We led the development of a multistakeholder support letter for the Improving Access to Medicare Coverage Act, which received support from more than 30 signing organizations.
SHM Goal: Advance health care delivery, quality, and experience through science and innovation
SHM has a long history of promoting and advancing the science of hospital medicine. Through our publications, The Hospitalist and the Journal of Hospital Medicine, our advocacy and practice management departments, as well as our successful center for quality improvement, we continue to support members and our field in providing high-quality care and enhanced patient outcomes.
There are two specific areas I wanted to highlight as part of our efforts in 2023, including the revised State of Hospital Medicine Report and a retreat SHM hosted at our national office, which focused on the future of hospital medicine research.
SHM’s State of Hospital Medicine Report was published in the summer of 2023. This report has been a key resource for many years on hospital medicine group composition and finances, including salary and hospital financial support. Hospitalists now earn as much as $323,500 annually!
But just as importantly, given the pivotal role played by hospitalists during the COVID-19 pandemic, SHM deployed a new, first-ever Workforce Experience Survey which captured patient load, perceived safety, and hospitalist well-being.
With more than 560 survey responses, there was a mixed picture of how hospitalists are doing. About 68% of respondents reported feeling at least some burnout, but at the same time, 86% reported their work as meaningful. So, we all have work to do to support and uplift our hospital-medicine workforce.
We are continuing to work with our staff and membership to develop new resources for hospitalists, based on the outcomes of this survey, and remain committed to being a partner to members like you.
Another key area where SHM is advancing the science of hospital medicine is partnering with our academic colleagues. To that end, in October, SHM hosted a group of hospital-medicine research leaders to explore areas where SHM could contribute to advancing research in hospital medicine.
Key opportunities identified during the one-day discussion included strategies we will explore for facilitating deeper representation of hospitalists in the development of guidelines, reviewing pathways modeled by other specialties (including emergency medicine and pediatric research), and defining a prioritized hospital-medicine research agenda.
I’m excited to partner with you to continue advancing not just these two goals, but all four, in the year ahead, to better meet your needs and the needs of all our hospital medicine team members. For more information on SHM’s recent accomplishments, I invite you to view the full SHM Annual Report!