AHA urges Congress to fund GME funding, expand residencies

The American Hospital Association has lobbied the U.S. Congress to preserve and boost payments for graduate medical education (GME), AHA News Now reported.

AHA Executive Vice President Rick Pollack sent a letter last week to Rep. Joseph R. Pitts, R-Pa, asking that he closely review and consider GME funding. Pitts chairs the healthcare subcommittee of the House Energy and Commerce Committee. Pitts had published an open letter last month seeking information about the GME program, and had requested input from relevant parties.

GME provides $14 billion a year to teaching hospitals to train the nation's doctors. The program has been under closer scrutiny in recent years. That's partly because such programs create more specialists than needed primary care physicians, and the fact that there are more medical school graduates than available internship and residency positions.

The Institute of Medicine issued a report last year suggesting that GME funding be revamped into a performance-based model and shift the funds to train more providers to practice in non-hospital settings.

"The AHA believes the current system provides relatively stable, predictable funding for training that is the envy of the world," Pollack wrote.

As a result, Pollack asked Congress to not only maintain the current revenue stream from Medicare (which covers the bulk of program funding), but from the Medicaid program and private payers as well, both of which make sporadic contributions. "Currently, neither Medicaid programs nor private payers have a statutory federal mandate to support GME. Many states do contribute to GME and private payers may provide higher reimbursement rates to teaching hospitals, but these additional payments vary greatly across states," Pollack wrote, adding it creates regional funding imbalances.

Pollack also asked that Congress lift a freeze on creating new residency positions, which were imposed in 1997 and have yet to be lifted. "The purpose and value of GME--assuring an adequate supply of well-trained physicians--will only increase as the U.S. population lives longer with more complex health conditions. The AHA urges the committee to end the 18-year freeze on the number of physician training positions that Medicare funds and to support the creation of at least 15,000 new residency positions," he wrote.

Meanwhile, three prominent healthcare scholars and educators have proposed a revamp of the GME program leadership in a recent Health Affairs blog post.

To learn more:
- read the AHA News Now article
- check out the Health Affairs blog post
- here's Rick Pollack's letter (.pdf)

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