The AAMC, in partnership with the Sheps Center for Health Services Research at the University of North Carolina, published an analysis of the hospitals that have participated in Section 131 of the Consolidated Appropriations Act, 2021 (P.L. 116-260). Section 131 allows certain hospitals to reset low per resident amounts (PRAs) or full-time equivalent (FTE) Medicare graduate medical education (GME) caps during a five-year period, which ends Dec. 26. Based on the most recent cost report information, of the 219 hospitals that were identified as eligible for resets, only 10.5% met the requirements for an FTE reset as of 2023. Hospitals with low PRAs or FTE counts face significant financial obstacles when it comes to operating GME programs.
The purpose of the legislation was to allow affected hospitals, primarily in rural and underserved areas, the opportunity to reset low PRAs or FTE counts, artificially reducing Medicare GME reimbursements. The program requires an eligible hospital to train a requisite number of residents to trigger a reset, which can be difficult at institutions that have had little or no GME activity. The report suggests that institutions need more time to plan for the required GME development and would benefit from congressional action to extend or make permanent Section 131.