FIGURE 1. AGE RANGE OF ACS GOVERNORS
FIGURE 2. PRACTICE SETTING
significant piece of legislation affecting GME was the
Balanced Budget Act (BBA) of 1997, which capped the
number of residency training positions that Medicare
would fund at approximately 100,000.1
Current public financing for GME is approximately
$15 billion per year. This money comes from multiple sources, with Medicare contributing 62. 5 percent
($9.7 billion), Medicaid contributing 25. 2 percent ($3.9
billion), the U.S. Department of Veterans Affairs contributing 9. 3 percent ($1.437 billion), and the U.S.
Health Resources & Services Administration contributing 3.0 percent ($464 million).
Medicare currently makes payments to teaching
hospitals through direct graduate medical education
(DGME) payments and indirect medical education
(IME) payments. DGME payments, which comprise
29 percent ($2.7 billion) of Medicare’s contribution to
GME, are paid out on a per resident basis to cover costs,
such as residents’ stipends and benefits, and compen-
sation to teaching faculty.
IME payments comprise 71 percent ($6.7 billion)
of Medicare’s contribution to GME and cover additional patient care costs due to the unique teaching
hospital mission of education and research.
3 The current system rewards teaching hospitals based on the
number of residents they train and the percentage of
publicly funded patients whom they treat.
Can the GME system produce
GME is a complex issue that affects the gamut of
health care challenges. At present, many health
policy experts are concerned with whether the GME
system can continue to produce enough physicians to
meet the evolving health care needs of U.S. patients.