IOM Identifies GME Problems, Calls for Finance Changes
The Surgical Coalition, representing 20 professional societies with 250,000 surgeons and anesthesiologists, was neutral, merely highlighting its estimate that the workforce shortage of doctors would grow to 130,600, including 64,800 specialists including surgeons, by the year 2025.
"At a minimum," the coalition wrote in a statement, "Congress should bolster the U.S. surgical workforce by lifting the cap." The Josiah Macy Jr. Foundation, a national group that strives to advance education and training of health professionals, said in a statement that it welcomed the call for a more "publically accountable" GME program.
The IOM made the following funding recommendations:
1. Maintain Medicare GME support at the current aggregate amount (i.e., the total of indirect medical education and direct graduate medical education expenditures in an agreed-on base year, adjusted annually for inflation) while taking essential steps to modernize GME payment methods based on performance, to ensure program oversight and accountability, and to incentivize innovation in the content and financing of GME. The current Medicare GME payment system should be phased out.
2. Build a GME policy and financing infrastructure.
2a. Create a GME Policy Council in the Office of the Secretary of the U.S. Department of Health and Human Services. Council members should be appointed by the Secretary and provided with sufficient funding, staff, and technical resources to fulfill (certain) responsibilities, such as development and oversight of a strategic plan for Medicare GME financing.
2b. Establish a GME Center within CMS in accordance with and fully responsive to the ongoing guidance of the GME Council.
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