A multi-hospital system can now have a single integrated medical staff, rather than requiring a separate medical staff at each hospital, under a final rule issued last week by the Centers for Medicare & Medicaid Services (CMS).
The rule amended certain provisions of the Medicare Conditions of Participation for Hospitals - an attempt by CMS to reduce regulatory burden - and focused in part on guidelines for medical staffs.
The AMA has advocated for CMS to require a separate medical staff at each hospital. CMS took a middle ground approach between the AMA’s advocacy and the urgings of other groups by requiring that medical staff at each hospital opt in to the integrated medical staff by majority vote, rather than be automatically included.
The final rule also removes an AMA-supported requirement that a hospital include a member of the medical staff on the hospital governing body. Instead, CMS will require that the governing body directly consult on a periodic basis with a designated member of the medical staff.
The AMA will continue to look for policy opportunities to advance physician leadership in hospitals, and will develop resources to help medical staffs influence their paths forward within their hospitals. For example, the AMA can provide guidance on why a medical staff may or may not wish to merge with a system-wide medical staff, alternative organizational models that promote coordination between hospitals within a system outside of a single medical staff model, and advice on how to best structure medical staff consultations with the governing body.
Through the work of its Professional Satisfaction and Practice Sustainability initiative, the AMA will continue to develop models to elevate the role of physician leadership and management in hospitals and engage the hospital community in adopting these models.
