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Geisinger's Long-Term Investment Plan to Eradicate Med School Debt, Strengthen Primary Care

Analysis  |  By Jack O'Brien  
   November 21, 2019

Jaewon Ryu, MD, JD, CEO of Geisinger Health sees the investment 'not just as tuition support' but as a way to build its primary care models.

Provider organizations are trying to prepare for the expected increase in medical care demands as baby boomers retire across the country.

As demands rise, the physician shortage is also expected to widen, with the Association of American Medical Colleges predicting that there will be a shortfall of 55,000 primary care physicians by 2032.

According to Geisinger Health CEO Jaewon Ryu, MD, JD, "we see 10,000 people aging into 65 every day in this country. As people age … they tend to be sicker. And so, there's an awful lot of chronic disease. And I think that the needs are profound in our community."

With complex challenges on the horizon, Geisinger decided to make a financial investment that will put the organization in the position to meet pressing clinical needs.

Related: Tuition-Free Med School Touches Off Multimillion-Dollar Debate

A no-debt option

Geisinger announced earlier this month that it will make its medical school tuition-free for students pursuing a career in primary care, a business move intended to help medical students avoid debt while driving the success of Geisinger's clinical care models. 

The Geisinger Primary Care Scholars Program will cover tuition plus a $2,000 monthly stipend for 40 students at the Geisinger Commonwealth School of Medicine. Tuition totaled $46,628 during the most recent academic year.

In exchange, graduates commit to becoming Geisinger-employed primary care physicians upon completion of their residency program and will have to complete at least two years of service at the organization.

Opinion: Free Med School Won't Solve the Doctor Shortage

Geisinger is the latest medical school to offer debt-free education, though Ryu tells HealthLeaders that the investment is not simply a financial one but also introduces students into the primary care space.

"This [program] is not just tuition support, it's bringing people that are passionate about primary care to a place where they're going to be able to scratch that itch across many different dimensions as opposed to just experiencing vanilla primary care," Ryu says.

Ryu says the health system won't see returns on its investment until at least seven years from now, when the first cohort finishes its residency programs. However, Ryu says the organization can make this investment because it has sizable financial and clinical resources.

"We have both the care and the financial coverage… to make big investments. I think for us, it makes all the sense in the world because of what we do and how we do it and the programs that we've accumulated and developed over time that differentiates us. I think, in that regard, we are very, very unique. There are a lot of innovative primary care models out there, but they're almost never affiliated with a hospital system," Ryu says.

Financial investment for a clinical mission

The debt-free tuition model for primary care helps the system achieve two goals: eradicate student debt and build up interest in that field.

Previously, Geisinger had trouble attracting students into primary care because of students' concerns of incurring medical school debt upon graduation, which is about $200,000 to $250,000, Ryu says. To be able to live while paying off debt, he says many students decide to opt for higher-paying careers as specialists and surgeons.

Related: New NYU Langone CFO Talks Free Tuition and Mission

With the introduction of a debt-free primary care option, Ryu expects students to choose a career that may pay less but still contributes greatly to the community.

"I think with the average medical student graduate and the debt burden that they have, sometimes it's a tougher decision to go into primary care," Ryu says. "We thought a program like this makes that decision easier for them."

The second goal is to develop a "robust, wraparound program" that reimagines the future of primary care and exposes students to the innovative primary care models Geisinger has developed for its patient population, Ryu says.

"We like to think of ourselves as the '31 flavors of primary care' because there are innovative care models that you don't see in a typical health system," Ryu says.

Primary care innovations

In recent years, the Scranton, Pennsylvania–based health system has implemented several differentiated primary care models, including its Geisinger at Home program.

This initiative aims to provide integrated clinical care for patients with “multi-morbid medical conditions” in their homes. The program features home-based medical care, community-based palliative care, and acute care supplied by mobile paramedics, says Ryu.

The results of this model have shown a 58% decline in emergency room visits and 31% decline in hospital admissions since the program was launched in spring 2018.

Additionally, Geisinger’s senior-focused primary care model has sought to redefine the doctor’s office experience for the older age group. This includes extended time with a physician during an appointment, more frequent office visits, and personalized care. Seniors also have access to the Geisinger 65 Forward Health Center that opened in late August, which is a "concierge-type primary care" that offers wellness and social programs, says Ryu.

Ryu says that having students rotate through these programs will expand their learning opportunities, align them with mentors in the field, and spark greater interest in primary care. 

Related: Univ. of Rochester Offers Free Tuition For New Employees in Four Nursing Programs

Jack O'Brien is the Content Team Lead and Finance Editor at HealthLeaders, an HCPro brand.

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