IOM Recommends Restructuring GME Financing

Medicare should continue to support graduate medical education, contingent on value

TUESDAY, July 29, 2014 (HealthDay News) -- Medicare support for graduate medical education (GME) should be restructured and based on its value and contribution to the nation's health needs, according to a report published July 29 by the Institute of Medicine (IOM).

Noting that the GME system needs to produce a physician workforce that meets the evolving needs of the population, Donald Berwick, M.D., M.P.P., cochair of the IOM Committee on the Governance and Financing of Graduate Medical Education, and colleagues analyzed the administration and funding of the GME system.

The authors note that there is a need for improvements to the GME system to address various concerns, including a mismatch between the health needs of the population and the specialty makeup of the physician workforce; the geographic maldistribution of physicians; and the lack of fiscal transparency. Recommendations for improving the system include maintaining GME support at the current aggregate amount while modernizing payment methods based on performance; building a GME policy and financing infrastructure; creating a Medicare GME fund which includes an operational fund and a transformation fund to finance new initiatives; modernizing GME payment methodology; and allowing GME funding to remain at the state's discretion, with mandated levels of transparency and accountability.

"It's time to modernize how graduate medical education is financed so that physicians are trained to meet today's needs for high-quality, patient-centered, affordable health care," a coauthor said in a statement.

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