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Contact: Media Relations Officer, (202) 828-0041.
AAMC Examines GME Funding Through State Medicaid Programs
Washington, D.C., April 20, 1999 -- Medicaid paid an estimated $2.3 billion for graduate medical education (GME) in 1998, according to a new survey from the Association of American Medical Colleges (AAMC). The survey entitled "Funding of Graduate Medical Education by State Medicaid Programs" was prepared for the AAMC by Tim M. Henderson, MSPH, of the National Conference of State Legislatures.
"This survey will serve as a valuable resource as policymakers examine Medicaid in today's changing health care marketplace and its role in supporting the training of new physicians and the other valued contributions provided by teaching hospitals," said AAMC President Jordan J. Cohen, M.D. "While much recent focus has been placed on Medicare's financing of GME, it is important to recognize and understand the integral role played by Medicaid in GME as well. This document provides good baseline information as we continue to advocate for stable, dedicated GME funding."
The survey queried Medicaid agencies in each of the 50 states, District of Columbia (D.C.), and Puerto Rico, to identify each agency's current or planned policies and issues associated with GME payments. A 100 percent response rate was obtained.
Medicaid is second only to Medicare as a source of funding for non-federal hospitals. However, according to the survey, while Medicaid fee-for-service programs in 43 states and D.C. made payments directly to teaching hospitals in 1998, only 16 states and D.C. made these same payments under their capitated managed care programs. Forty-two states and D.C. have capitated Medicaid managed care programs.
"As Medicaid managed care continues to grow, it is increasingly important that these programs identify mechanisms to ensure that the service and education missions of U.S. teaching hospitals are sustained," said Dr. Cohen.
Other findings from the AAMC survey include:
- Medicaid GME payments on average represent 7 to 8 percent of total Medicaid inpatient hospital expenditures;
- Medicaid agencies in Alaska, Idaho, Illinois, Montana, South Dakota, and Puerto Rico do not pay for GME; Five states (Connecticut, Mississippi, North Carolina, Texas, and Utah) report they are currently considering a formal proposal for making explicit GME payments to teaching hospitals under managed care; and,
- A growing number of states see the opportunity to distribute Medicaid GME funds in a manner more explicitly accountable to the public. Ten states reported that they require that some or all Medicaid GME payments be directly linked to state policy goals intended to vary the distribution of or limit the health care workforce.
If you would like a copy of the survey, please contact Media Relations Officer.
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The Association of American Medical Colleges represents the 125 accredited U.S. medical schools; the 16 accredited Canadian medical schools; some 400 major teaching hospitals, including 74 Veterans Administration medical centers; 87 academic and professional societies representing nearly 88,000 faculty members; and the nation's 67,000 medical students and 102,000 residents.
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