Reimagining Nephrology Fellowship Education to Meet the Future Needs of Nephrology: A Report of the American Society of Nephrology Task Force on the Future of Nephrology.

The American Society of Nephrology (ASN) Task Force on the Future of Nephrology was established in April 2022 in response to requests from the American Board of Internal Medicine and the Accreditation Council for Graduate Medical Education regarding training requirements in nephrology. Given recent changes in kidney care, ASN also charged the task force with reconsidering all aspects of the specialty's future to ensure that nephrologists are prepared to provide high-quality care for people with kidney diseases. The task force engaged multiple stakeholders to develop 10 recommendations focused on strategies needed to promote: ( 1 ) just, equitable, and high-quality care for people living with kidney diseases; ( 2 ) the value of nephrology as a specialty to nephrologists, the future nephrology workforce, the health care system, the public, and government; and ( 3 ) innovation and personalization of nephrology education across the scope of medical training.

Lessons to Learn From Hahnemann University Hospital's Closure.

Despite the number of hospital closures over the past decade, the June 2019 announcement of the closing of Hahnemann University Hospital (HUH) in downtown Philadelphia has greatly impacted the academic medicine community. Several factors contributed to the collapse of the hospital; however, the operational approach throughout the period leading up to and during the hospital's closing left faculty, students, and especially residents with many questions as they scrambled to determine how to continue their careers. This Invited Commentary examines factors that contributed to the crisis following the hospital's closure, such as the influence of HUH's ownership history and the complicated landscape of graduate medical education, and discusses the lessons that can be learned from this cataclysmic event.

The Decline In Rural Medical Students: A Growing Gap In Geographic Diversity Threatens The Rural Physician Workforce.

Growing up in a rural setting is a strong predictor of future rural practice for physicians. This study reports on the fifteen-year decline in the number of rural medical students, culminating in rural students' representing less than 5 percent of all incoming medical students in 2017. Furthermore, students from underrepresented racial/ethnic minority groups in medicine (URM) with rural backgrounds made up less than 0.

Financial and Clinical Impact of Transfer Patients at Major Teaching Hospitals.

Purpose: The authors examined the "hub-and-spoke" health care system in the United States for patients transferred from one hospital ("spoke") to a major teaching hospital ("hub") and assessed the financial and clinical impact of this system on major teaching hospitals.

Method: The authors surveyed Council of Teaching Hospitals and Health Systems members to collect detailed financial and clinical data from fiscal year 2015 for transfer cases and nontransfer cases (cases directly admitted to the teaching hospital). Data included computed margins (the difference between revenue received and direct and indirect facility costs as estimated by the hospitals) as well as case severity, average length of stay (ALOS), time of admission, surgical or medical status, and other situational variables for All Patient Refined Diagnosis Related Groups (APR-DRGs).

Looking Under the Streetlight? A Framework for Differentiating Performance Measures by Level of Care in a Value-Based Payment Environment.

The majority of quality measures used to assess providers and hospitals are based on easily obtained data, focused on a few dimensions of quality, and developed mainly for primary/community care and population health. While this approach supports efforts focused on addressing the triple aim of health care, many current quality report cards and assessments do not reflect the breadth or complexity of many referral center practices.In this article, the authors highlight the differences between population health efforts and referral care and address issues related to value measurement and performance assessment.

Taking Risk: Early Results From Teaching Hospitals' Participation in the Center for Medicare and Medicaid Innovation Bundled Payments for Care Improvement Initiative.

The authors describe observations from the 27 teaching hospitals constituting the Association of American Medical Colleges (AAMC) cohort in the Center for Medicare and Medicaid Innovation (CMMI) Bundled Payments for Care Improvement (BPCI) initiative. CMMI introduced BPCI in August 2011 and selected the first set of participants in January 2013. BPCI participants enter into Medicare payment arrangements for episodes of care for which they take financial risk.

The Nation's Physician Workforce and Future Challenges.

There is much debate about the adequacy of the U.S. physician workforce and projections of its future size, distribution and composition.

Yes, It Is Time to Rethink Postgraduate Training Requirements for Licensure!

In his Commentary in this issue, Dr. Freeman asks whether it is time to rethink postgraduate training requirements for licensure. The majority of U.

Multiple listing in kidney transplantation.

The increasing number of patients with end-stage renal disease and the expanding waiting lists for various solid-organ transplants, particularly kidney transplants, has compelled prospective transplant recipients and their care teams to explore novel ways to accelerate this process, initiating the practice of multiple listing. Multiple listing is defined as being listed for an organ transplant at more than 1 transplant center. Current policy allows patients to be listed at more than 1 transplant center in 1 or more organ procurement organization.