Changes coming to GME

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It is about the IOM recommendation for residency funding. They hope to move some funding towards generalists and away from specialists, spread out physicians geographically, and improve quality, "care coordination, team-based care, costs of care, health information technology, cultural competence, and quality improvement"

As best I can tell, the key points are
1) Keep total GME funding the same, but reallocate it with new infrastructure (below) over a 10 year period
2) The infrastructure will be split into two parts:
a. Graduate Medical Education Policy Council within the HHS Secretary's Office to oversee policy and decision making
b. Centers for Medicare & Medicaid Services to oversee fund distribution.
3) 2 distinct funds for Medicare support:
a. an operational fund to finance ongoing residency training activities. Payment will be a flat amount per resident instead of a formula to determine support.
b. a "transformational fund to finance new training slots where needed, provide technical support, and support much needed research and innovative pilot programs."
 
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Well that is good news because it means decreased funding for training of pathologists in order to increasing funding to create more family practice docs and general pediatricians. While a good family practice doc can probably do a lot of what a cardiologist or gi doc does in terms of medical management, they sure as hell can't do what a pathologist does.

Now just as long as they quit slashing our reimbursement, we are going to be ok.
 
Whatever it is it needs to be gradual, which is good that that is in the "proposal." Significant changes will have to be accounted for and adjusted for.

Many institutions will probably eliminate residency programs in favor of ancillary professionals, but others won't. It depends on the specific goals. The question I wonder is whether residency pay will stay the same. If they slash residency pay at the same time they are slashing practicing MD pay and they are doing nothing about rising tuition costs that is going to be a major problem, although it won't really be a problem for anyone making decisions unfortunately.
 
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