Skip to main content
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Digital Health
    • Transformation
    • ESG
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Opinion
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • ESG: The Implementation Imperative Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Hospital at Home
    • - Workplace of the Future
    • - Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • Data Center
    • Data Center Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • Newsletters
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Government
November 06, 2013 12:00 AM

Report links imbalance in graduate medical education payments, doc shortages

Andis Robeznieks
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print

    Physician shortages in states with rural and growing populations have been exacerbated by the Balanced Budget Act of 1997, because the law essentially gave ownership of a capped number of federally supported residency slots to hospitals that had them at the time, according to a new study.

    The Northeast in general and New York in particular are getting a disproportionate share of Medicare graduate medical education payments compared with growing states such as Florida and states with physician shortages such as Mississippi, according to the report by researchers from the George Washington University School of Public Health and Health Services in Washington.

    New York has more medical residents than 31 other states combined and received almost 20% of all Medicare GME funding while 29 other states received less than 1%.

    The uneven distribution of GME, researchers wrote, is important because it raises questions of fairness and because physicians tend to practice where they train.

    “Unless the GME payment system is reformed, the skewed payments will continue to promote an imbalance in physician availability across the country,” Dr. Fitzhugh Mullan, the study's lead author and a professor of medicine and health policy at George Washington University, said in a news release.

    According to Mullan's study, medical schools in New York, Massachusetts and Pennsylvania “took root in the first half of the 20th century” and were “well positioned to take full advantage” of a Medicare-funded medical education system.

    Medicare spent $10.1 billion in 2010 to support the training of medical residents and fellows. But about 15,300 resident positions have been created since 1997 that don't rely on Medicare funding, authors noted. To boost their supply of physicians, some states have been contributing more to GME efforts, most notably New Jersey and Florida.

    While Kenneth Raske, president of the Greater New York Hospital Association, didn't dispute Mullan's statistics, he disagreed with his conclusions.

    “We produce the largest number of physicians in the United States by a long shot,” Raske said, explaining that “historical decisions” led to his state's dominance in GME, and he compared it to decisions that resulted in all the major automobile companies being headquartered in Detroit.

    He also disagreed that concentrating GME in New York leads to physician shortages in other states. “We have shipped doctors all over the United States,” Raske said. “To believe they are landlocked in the place they trained is incorrect.”

    Raske cited an October 2011 report by the State University of New York University at Albany's Center for Health Workforce Studies, which found that New York GME programs trained more than 17% of the nation's physicians—including 41.5% of doctors in New Jersey, 28.5% in Connecticut and 18.6% in Florida. While the Health Affairs report suggests that New York's GME funding may come at the expense of Mississippi, the 2011 CHWS report noted that 330 of Mississippi's 5,752 doctors (5.7%) were trained in New York.

    Karen Heller, GNYHA executive vice president, said increasing funding for GME is what's needed and not redistribution of existing positions. “It doesn't make sense to redistribute because that's a zero-sum game,” Heller said. “Why do people come to New York to train? Because you get experiences that you can't find in other areas. They train here and then they go home.”

    According to a study published in Health Affairs in January, a redistribution of some 3,000 GME slots mandated by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 failed to reduce primary-care and rural physician shortages as intended.

    Follow Andis Robeznieks on Twitter: @MHARobeznieks

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    abortion-pill-misoprostol-legal
    Abortion pill case advances to appeals court, on course to Supreme Court
    young doctor medical resident
    Federal physician recruitment program at risk
    Most Popular
    1
    More healthcare organizations at risk of credit default, Moody's says
    2
    Centene fills out senior executive team with new president, COO
    3
    SCAN, CareOregon plan to merge into the HealthRight Group
    4
    Blue Cross Blue Shield of Michigan unveils big push that lets physicians take on risk, reap rewards
    5
    Bright Health weighs reverse stock split as delisting looms
    Sponsored Content
    Modern Healthcare Alert: Sign up for this breaking news email to be kept in the loop as urgent healthcare business news unfolds.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Digital Health
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • ESG
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Opinion
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Hospital at Home
        • - Workplace of the Future
        • - Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • Data Center
      • Data Center Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • Newsletters
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Jobs
      • People on the Move
      • Reprints & Licensing