The Medicare Payment Advisory Commission in a series of recommendations is calling on Congress to overhaul Medicare's graduate medical education, or GME, payments so that institutions are paid based on performance standards.
The purpose of these recommendations is to support workforce skills that would reduce cost growth while improving quality, the commission stated.
HHS should establish standards for distributing funds to GME institutions that specify “ambitious goals” for practice-based learning and improvement, using overpayments made to the indirect medical education pool to fund the new performance-based program.
Institutions would get paid based on how well they performed on the standards. In addition, HHS should annually publish a report that shows what each institution receives in Medicare medical education payments and what their associated costs are.
GME in the U.S. is viewed as a model program by the rest of the world, yet the commission's staff “has uncovered some deficits” within the system, MedPAC Chairman Glenn Hackbarth said.
More transparency and accountability need to be introduced into the system, MedPAC researchers said.
Medicare's GME payments are made to hospitals to help support residency programs, but the programs are reporting that hospitals' budgeting decisions for supporting GME “are often obscured from educators,” the researchers found. In addition, Medicare's payments to teaching hospitals don't necessarily reflect the quality of affiliated residency programs or institutional support.
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