Skip to main content
Sister Publication Links
  • ESG: THE NEW IMPERATIVE
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • COVID-19
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Transformation
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Digital Health
  • Insights
    • ACA 10 Years After
    • Best Practices
    • Special Reports
    • Innovations
  • 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 25 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
    • 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
    • - Supply Chain
    • - 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
  • MORE +
    • Contact Us
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Politics & Policy
April 23, 2021 04:18 PM

Congress eyes adding more Medicare GME slots in infrastructure package

Jessie Hellmann
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print
    Getty Images/Caiaimage

    Physician and hospital groups are hopeful Congress will approve thousands of additional Graduate Medical Education slots this year which, if successful, would mark one of the biggest expansions to the program seen in decades.

     

    Citing a looming physician shortage, doctors and providers have lobbied Congress for more than a decade to increase the number of residents Medicare helps pay to train. That number has been frozen since 1996 until Congress approved an additional 1,000 slots in December.

     

    Lobbyists say that was the catalyst needed to break a decades-long resistance to expanding the program, with provider groups pushing for an additional 14,000 slots this year.

     

    "It was COVID I think that spurred everyone into seeing we can't have this artificial cap in place. It's too restrictive on our healthcare system," said Jon Cooper, senior vice president of government affairs, communications and public policy for the Greater New York Hospital Association.

     

    There are talks on Capitol Hill about including the more funded GME slots in the infrastructure packages Congress is working on, though discussions are still in the early stages.

     

    "We think the time is right, the momentum is there, and we're hoping it's included," Cooper said.

     

    The Association of American Medical Colleges projects a shortage of 54,100 to 139,000 physicians by 2033, citing retirements, burnout, and a growth in the aging population that needs more medical care.

     

    The GME push has some influential backers in Congress including Senate Majority Leader Chuck Schumer (D-N.Y.) and House Ways & Means Committee Chairman Richard Neal (D-Mass.), both strong allies of the hospital industry.

     

    Any infrastructure provisions that touch on Medicare spending would need to move through Ways & Means, and Neal has been pushing hard on the GME issue, according to lobbyists and his staff.

     

    "Chairman Neal is concerned about the future of the physician workforce and wants to be sure we are investing now to build one that matches the diversity of our country," a Neal spokesperson told Modern Healthcare. "He's looking into a visionary policy to create the pipeline to practice that's needed to bring more people from underrepresented groups into the fold and support them throughout their training."

     

    Proposals from Sens. Robert Menendez (D-N.J.), John Boozman (R-Ark.), Schumer, and Rep. Terri Sewell (D-Ala.) would add an additional 14,000 slots over a seven-year period, and target some of those positions to rural hospitals, areas with shortages of health professionals and hospitals training over their GME caps.

     

    Those targets were key to getting the 1,000 slots passed in December, lobbyists say, and similar targets are included in the new bills.

     

    A 2018 report from the Government Accountability Office found that most residents train in certain urban centers in the northeast. And 99 % of spending on GME training was used to support training in urban areas. It's likely more than 1% of spending goes to training in rural areas, GAO said, but the lack of data makes it difficult to know for certain.

     

    Now as lawmakers are debating what to include in a multitrillion-dollar infrastructure package, physician groups are arguing that addressing shortages in the healthcare workforce should be part of it.

     

    "As we see it at the AHA, infrastructure means bricks and mortar, roads and bridges, and broadband, but it also means investment in human resources that provide for the most urgent needs of the nation," said Priscilla Ross, senior associate director for federal relations at the American Hospital Association. "I think Congress as a whole sees this as beneficial to meeting the growing needs of the patients they represent."

     

    But cost may be an obstacle.

     

    There are competing priorities for what should be included in an infrastructure bill. If Democrats choose to use reconciliation—a budget maneuver that is immune to the filibuster and only needs a simple majority to pass—they will face additional cost restraints.

     

    Training residents is expensive. Lawmakers froze the number of GME slots in 1996 fearing a oversupply of residents as hospitals added more and more positions with no restrictions on how many Medicare would help pay for.

     

    In 2015, the most recent year data was available, Medicare spent more than $10 billion on 88,000 GME slots, according to the GAO.

     

    "I think there's always cost concerns. We certainly recognize that this is a significant investment we're asking Congress to make but I'm always concerned about what's the cost of not acting and what's the impact on the health of our nation and what it means for access?" said Leonard Marquez, senior director of government relations and legislative advocacy at AAMC.

    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
    Copy of congressional_266dpi_CORRECT_i.jpg
    House passes $1.7T spending bill
    congress, capitol building, legislation
    Senate passes $1.7T bill to fund government
    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
      • COVID-19
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Digital Health
    • Insights
      • ACA 10 Years After
      • Best Practices
      • Special Reports
      • Innovations
    • 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 25 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
        • 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
        • - Supply Chain
        • - 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
    • MORE +
      • Contact Us
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing