How Hospitals Can Recoup Revenue on Resident-rendered Services

HealthLeaders Media Staff, January 18, 2011

Trainees perform a significant number of unsupervised procedures on patients with private insurance but are prohibited from billing for those services. And that represents a significant amount of lost income for teaching institutions. This is the conclusion reached by the authors of a study published in The Journal of Trauma -- Injury, Infection, and Critical Care.

Billing private insurers for these services might help offset the costs of graduate medical education, the authors suggest.

Medicare does not let residents and fellows bill for services, and for good reason: Medicare already supplements hospitals via medical education funds. Reimbursement for trainee services would amount to double billing, explains the lead author, Ara J. Feinstein, MD, MPH, a trauma surgeon who is clinical assistant professor and surgical clerkship director at University of Arizona College of Medicine in Phoenix.

The problem, according to the authors is this: Private insurance companies benefit financially from Medicare billing regulations without contributing to the expense of education.

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