Graduate Medical Education: Targeting Medicare's Investment?
September 6, 2013
William J. Scanlon, PhD, Consultant & Sally Coberly, PhD
Graduate Medical Education (GME) is a large and complex undertaking with over 115,000 residents training in more than 9,000 programs nationwide. About $15 billion in public funding from Medicare, Medicaid, the Veterans Health Administration, and the Department of Defense supplement hospital and other institutional sponsors’ revenues in GME financing. Calls have been made for reducing Medicare’s contribution and for redirecting a portion to influence the composition and skills of the future physician workforce. This Forum session examined the fundamentals of GME financing, the Medicare Payment Advisory Commission’s analysis of Medicare’s role, and recommendations for tying payment to meeting societal objectives. How GME is changing, independent of any shift in Medicare policies, to produce physicians better equipped to deal with anticipated care delivery reforms were also discussed.
Medicare Payment Advisory Commission, "Graduate medical education financing: Focusing on educational priorities," ch. 4 in Report to the Congress: Aligning Incentives in Medicare, June 2010.
Robert B. Baron, "Can We Achieve Public Accountability for Graduate Medical Education Outcomes?" Academic Medicine, 88, no. 9 (September 2013): pp. 1199–1201.
Rob Cunningham, "Aligning Graduate Medical Education with Public Policy," National Health Policy Forum, Background Paper No. 82, September 14, 2011.
Council on Graduate Medical Education, "Improving Value in Graduate Medical Education," Twenty-First Report, August 2013.
Macy Foundation, Ensuring an Effective Physician Workforce for America: Recommendations for an Accountable Graduate Medical Education System, November 2010.