GME Funding Cuts?

[jotfinos]

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This article is specific to MA but the cuts would affect teaching hospitals all over the country.

We already have a residency shortage as is and this could potentially eliminate some of the existing programs.

What kind of priority is given to funding for pod residencies?

Would our programs be eliminated before the MD/DO residencies?



http://www.boston.com/news/nation/articles/2011/07/08/medicare_cuts_may_fall_hard_on_boston_teaching_hospitals/


"Massachusetts teaching hospitals would lose $322 million, or about two-thirds of the federal dollars they receive for the training of medical residents, under a bipartisan proposal to tamp down the rising costs of Medicare and reduce the federal deficit."

"For the hospitals, a $322 million reduction in Medicare reimburse ments - a one-time cut that would be in force for at least a decade - would be devastating, industry representatives said. Training programs would be eviscerated, with fewer doctors taught and fewer specialties served. Cuts in other hospital jobs and specialized services such as burn and transplant centers would be inevitable, they said."

 

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Podiatry residencies should not be affected by this.

We are also one of the few professions that don't have a cap on Medicare funding atm. This means that as long as the CPME approves positions (with a teaching hospital's cooperation), funding should be available for those positions.

 

[Podfather]

Podiatry residencies should not be affected by this.

We are also one of the few professions that don't have a cap on Medicare funding atm. This means that as long as the CPME approves positions (with a teaching hospital's cooperation), funding should be available for those positions.

Well not so fast. The cap issue is one thing and in fact they already are awarding new positions for MD positions and taking them away from those who do not use them. This is different. There has been rumors for atleast 10 years that Medicare was eventually going to address the fact that they (and hence the tax payers) solely pay for residency education. For those anti-government people the government has always picked up the tab for residency and to a lessor extent fellowship training. Those of us in residency education have been waiting for the shoe to drop.

One concept is to keep the funding the same but only pay based upon the percent of Medicare patients. So if hospital X is allocated 50,000 in direct expenses per FTE and Medicare admissions are 50% you now get 25,000 and BC/BS, Aetna etc should pick up the rest. Another approach is only paying direct an no indirect (the higher number) and drastically cut funding.

I do not believe anything will happen to Podiatry soon but with the political theme of the day being cost reduction and debt control we will see some effect. Without starting a political firestorm this is where medicine gets tricking. Private insurers get to cherry pick patients and are not required to pay for residency training. Medicare gets the sickest patients and picks up the tab for residency training (9 billion a year). A large percentage of healthcare costs are for the last 6 months of life (Medicare patients are the majority) and yet private insurers raise premiums, cut reimbursement, and reap huge profits. It seems socialistic medicine is OK for the expensive parts and capitialism works for the monopoly. Cake and eat it too.

In the end Podiatry will survive and adapt and is often more prepared than MD/DOs. We have had to always fight and scratch our way while the others were hard workers that rarely had to fight. That is why my generation took little or no pay as residents when our MD and DO friends were actually paid. We are like the cockroaches hard to kill.