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Increase Medicare Support for Graduate Medical Education (GME)

September 10, 2019

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PRESS CONTACTS
Allyson Perleoni, Senior Legislative Analyst
Len Marquez, Senior Director, Government Relations

Background

The United States is facing a serious shortage of physicians, between 46,900 and 121,900 by 2032. This is largely due to a growing and aging population and the impending retirements of older physicians. Because it takes up to 10 years to train a doctor, looming shortages must be addressed now before they become inevitable. 

Congress must act now to address the physician shortage crisis. Medicare’s support for training residents has been effectively frozen since 1997, due to caps on the number of medical residents that will be supported. While Medicare support is critical, the program covers only about 20% of the total costs of the training, with states and teaching hospitals themselves offsetting the rest. 

The Resident Physician Shortage Reduction Act of 2019 (S. 348, H.R. 1763) is bipartisan legislation introduced by Sens. Menendez (D-N.J.), Boozman (R-Ark.), and Schumer (D-N.Y.) and Reps. Sewell (D-Ala.) and Katko (R-N.Y.). The legislation:

  • Increases, by 15,000 over 5 years , the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) slots.
  • Distribution methodology awards priority to teaching hospitals in states with new medical schools or new branch campuses, or currently training over their Medicare cap, followed by other criteria.
  • Half of the slots must be used for shortage specialty residency programs.
  • Requires the Government Accountability Office (GAO) to conduct a study on strategies for increasing health professional workforce diversity.

The Opioid Workforce Act of 2019 (H.R. 3414), introduced in the House by Reps. Brad Schneider (D-Ill.), Susan Brooks (R-Ind.), Ann Kuster (D-N.H.), and Elise Stefanik (R-N.Y.), is a targeted and important step that Congress must take to help ensure a robust physician workforce that can deliver high-quality care to those suffering from substance abuse disorders.

  • Increases by 1,000 the number of Medicare-supported direct graduate medical education (DGME) and indirect medical education (IME) slots available to hospitals that have, or are in the process of establishing, approved residency programs in addiction medicine, addiction psychiatry, or pain medicine.
  • According to the Substance Abuse and Mental Health Services Administration, in 2016, approximately 21 million people needed treatment for a substance abuse disorder, however only 11 percent were treated.
  • One reason for this disparity is a shortage of physicians trained in addiction medicine, addiction psychiatry, or pain management. The lack of physicians trained in these specialties reflects the nation’s larger physician shortages. Funding new, targeted residency positions will strengthen the health care workforce and help mitigate the effects of the overall physician shortage.

Recommendations

Congress should pass the bipartisan Resident Physician Shortage Reduction Act of 2019 (S. 348, H.R. 1763) and the bipartisan Opioid Workforce Act of 2019 (H.R. 3414).  S. 348/H.R. 1763 would responsibly lift the cap on Medicare-support for GME by increasing the number of Medicare-supported residency positions by 3,000 a year for 5 years. This increase will still fall short of meeting the nation’s projected need, but is an important first step in addressing the physician shortage.

H.R. 3414 would increase by 1,000 the number of Medicare-supported slots available to hospitals that have, or are in the process of establishing, approved residency programs in addiction medicine, addiction psychiatry, or pain medicine.
 

 

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