Congress Approves New GME Slots

The year-end federal COVID-19 relief bill brought changes to Medicare’s graduate medical education program.

Among those changes:

  • 200 new GME slots over the next five years
  • additional federal funding for residency training – the first new funding for the program in nearly a quarter of a century
  • new opportunities for some hospitals to establish new (and higher) resident caps
  • new flexibilities for rural hospitals to participate in physician training programs

Learn more in the National Law Review article “COVID-19: Reimbursement Corner: Graduate Medical Education Gets Major Boost From Congressional Appropriations Bill.”

CMS Finalizes FY 2021 Payments to Hospitals

Medicare has announced how it will pay hospitals for inpatient care in FY 2021 with publication of its annual inpatient prospective payment system regulation last week.

Among the changes announced by the Centers for Medicare & Medicaid Services:

  • A 2.9 percent increase in fee-for-service inpatient rates.
  • A compromise on its proposal to require hospitals to report their payer-specific negotiated rates with Medicare Advantage plans.
  • Changes in how Medicare will calculate Medicare disproportionate share (Medicare DSH) uncompensated care payments.
  • A much smaller cut than originally proposed in the pool of funds for Medicare DSH uncompensated care payments.  Medicare DSH uncompensated care payments are especially important to private safety-net hospitals.
  • Minor adjustments in the Medicare area wage index system.
  • Refinements in the Medicare graduate medical education program.
  • A new DRG for CAR T-cell payments and a new pathway to Medicare add-on payments for FDA-approved antimicrobial products.

Learn more from CMS’s fact sheet or see the final regulation itself.

Medicare Money for Nurse Practitioner and Physician Assistant Training?

Should Medicare offer graduate medical education money for nurse practitioner and physician assistant training?

That was the subject of a recent inquiry by the U.S. Government Accountability Office.

In a new report inspired by concern over the current physician shortage and the belief that making greater use of nurse practitioners might help relieve that shortage, the GAO examined whether expanding Medicare’s graduate medical education (GME) program to include resources for the training of nurse practitioners and physician assistants was practical or possible.  As part of its research, the GAO reviewed current literature, interviewed officials of professional associations, and explored the financial and academic implications of a greater federal role in the training of nurse practitioners and physician assistants.

The possibility of GME funding for nurse practitioner and physician assistant training would be of great interest to the many private safety-net hospitals that have medical education programs.

Read about what the GAO learned in its new report Views on Expanding Medicare Graduate Medical Education Funding to Nurse Practitioners and Physician Assistants

Graduate Medical Education: Boon or Bane for Hospitals’ Bottom Line?

Do hospitals make money on graduate medical education? Do they lose money subsidizing positions above and beyond the funding they receive for completing the training of the next generation of doctors? Are there other benefits hospitals reap from medical education training programs – and are those benefits worth the cost?

Stock PhotoThis is an important question for the many private safety-net hospitals that also are teaching hospitals.

Crain’s Detroit Business has taken a look at some of the surprisingly complex considerations that go into answering what seem like very simple questions. Go here for its report “Hospitals say they subsidize graduate medical education, but cost-benefit unknown.”