Pending bill would increase GME slots, but at what cost? > Michigan State Medical Society

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Pending bill would increase GME slots, but at what cost?

from AMA MedEd Update
September 2012

Graduate medical education (GME) slots in the United States would rise by 15,000 and a teaching hospital could receive up to 75 new residency slots if it meets certain eligibility requirements under bipartisan legislation introduced earlier this month in the U.S. House of Representatives.

The legislation, introduced Aug. 2 in the House, would also require adjusting Medicare Indirect Medical Education (IME) payments by two percent based on a hospital's performance on and reporting of quality measures.

This means hospitals that do not meet these standards would face a two percent reduction in IME payments—a significant concern, as two-thirds of Medicare funding for GME comes through IME payments.

The bill also would require the Government Accountability Office to issue reports on GME and would require an annual transparency report from the U.S. Department of Health and Human Services that explains how each hospital uses its GME funding.

The AMA supports increasing GME slots, as underscored by AMA policy, but believes there are challenges with tying quality reporting and performance requirements to IME payment levels.

In related news:

  • The Institute of Medicine has named the members of its committee to examine GME governance and financing. 
  • An Aug. 27 article in American Medical News looks at the GME funding "showdown" in Washington. 
  • D. Craig Brater, MD, dean of the Indiana University School of Medicine, writes in The Indianapolis Star that more residency slots are needed to ease the nation's doctor shortage.
  • A new Health Affairs policy brief examines the ongoing debate over the size and scope of federal subsidies to support residency training. 
  • A commentary in The Atlantic calls for systemic change in reimbursements to encourage more physicians to enter primary care. 
  • An article in Forbes looks at the growth in medical schools to address the physician shortage—and notes the need for more residency program slots as well.
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