The AAMC Oct. 14 submitted a letter to the Medicare Payment Advisory Commission (MedPAC) Chair Francis J. Crosson, MD, regarding the commission’s recent discussion on Medicare’s Indirect Medical Education (IME) payment policy [see Washington Highlights, Sept. 6].
The discussion focused on the potential reallocation of existing IME payments to support the existing inpatient IME, as well as a new outpatient IME adjustment, and the addition of a performance-based pool.
The AAMC’s letter expressed support for the creation of a new outpatient IME adjustment that would be paid in addition to existing inpatient IME payments, but emphasized that MedPAC’s suggestion to reallocate inpatient IME payments to create a new outpatient IME adjustment would likely cause significant harm to individual institutions.
The letter stressed the already low Medicare margins of AAMC member teaching hospitals and the potential impact of reallocating IME payments and withholding payments to create a performance-based pool. The AAMC’s letter also clarified commissioners’ confusion concerning the purposes of Medicare IME payments, underscoring that IME payments are related to costs incurred for patient care, whereas direct graduate medical education payments are related to the costs of training the physician workforce. Finally, the AAMC offered its support and expertise to MedPAC as it further explores development of an outpatient IME adjustment.