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IOM GME Committee Holds First Public Meeting

September 7, 2012—The Institute of Medicine (IOM) Governance and Financing of Graduate Medical Education (GME) Committee Sept. 4-5 held its first public meeting to discuss the health care workforce, health services, coverage and access, select populations, and health disparities. The committee heard speakers from the Centers for Medicare and Medicaid Services (CMS); the Health Resources and Services Administration (HRSA); the Departments of Veteran Affairs (VA) and Defense; and congressional staff from the House Energy and Commerce, House Ways and Means, and Senate Finance committees.

Marc Hartstein, acting director, Hospital and Ambulatory Policy Group, Center for Medicare, and Dianne Heffron, director, Financial Management Group, Center for Medicaid and Children’s Health Insurance Plan (CHIP), presented on Medicare and Medicaid’s role in funding GME ― both direct graduate medical education (DGME) to help fund the training of residents and indirect medical education (IME) to help offset the higher costs of patient care and the special missions of teaching hospitals.

Mary Wakefield, administrator, HRSA, discussed the role of HRSA in supporting workforce programs that focus on underserved communities and training providers to serve them. She also highlighted the role of the National Health Service Corps (NHSC) to assist these missions.

Congressional staff advised the committee to look at broad workforce issues from primary care to specialist shortages, the role of other health care providers, the need for more residency positions, and training in a variety of settings.  They also requested that the committee examine the many factors that influence physician practice choice and review the Affordable Care Act (P.L. 111-148, P.L. 111-152) provisions that invested in primary care to facilitate training in outpatient settings. Additionally, congressional staff raised the question of how GME will train physicians in skills for the next century such as health information technology (HIT), teamwork, systems and quality improvement, and coordination of care.

The IOM GME committee was tasked to review, among other topics: the numbers of residents, GME slots, and balance of primary care providers, specialists, and subspecialists; training sites; financing options; the accreditation process; relevant provisions of Titles III, VII, and VIII of the Public Health Services Act; and relationships among safety net providers, community health/teaching health centers, and academic centers [see Washington Highlights, Aug. 3]. The committee will hold its second public hearing Dec. 20-21.


Len Marquez
Director, Government Relations
Telephone: 202-862-6281


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Jason Kleinman
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