The report recommends that the federal government change the way Medicare funds physician training over the next 10 years. Currently, that government spends about $15 billion a year on funding for GME. Nearly two-thirds of that comes from Medicare.
The IOM report also calls for a change in GME governance by establishing a two-branch infrastructure, and recommends the creation of a two-tiered Medicare GME fund: the Operational Fund, which would sponsor continuing residency training, and the Transformation Fund, which would help develop new infrastructure, programs, payment demonstrations, and performance methods.
According to media reports, some organizations are critical of the report, including the American Medical Association (AMA) and the Association of American Medical Colleges (AAMC). The AMA Wire reports, “Adding additional funds to the system, however, isn’t one of the recommendations—a fact that concerns the AMA.” in a statement, AMA Immediate Past President Ardis Dee Hoven, MD, said, “Despite the fact that workforce experts predict a shortage of more than 45,000 primary care and 46,000 specialty physicians in the U.S. by 2020, the report provides no clear solution to increasing the overall number of graduate medical education positions to ensure there are enough physicians to meet actual workforce needs.”
The AAMC said that they felt the report’s recommendations would threaten physician training and jeopardize patients in the teaching hospitals the AAMC represents.
On a state level, increased funding for physicians-in-training is a top issue for the Pennsylvania Medical Society (PAMED). During this year’s state budget process, PAMED successfully advocated for a $1 million increase in the Primary Health Care Practitioner appropriation. Representing a more than 27 percent increase from the previous year, these funds will provide additional opportunities for medical student loan forgiveness and create new primary care residency slots.