![]() ![]() Additionally, provisions in the CAA allow for adjustments to low Per Resident Amounts (PRAs) that were generated by inbound rotators, enhancing the capabilities of hospitals with artificially low PRAs to better finance residency program overhead and faculty salaries. Though the overall number of new positions available was relatively small (200 positions per year for 5 years, a 1% increase in funded slots), the prioritization of these positions to hospitals in rural and underserved areas as well as states with new medical schools creates a rare opportunity for community health systems to potential build or expand their own GME programs. The Consolidated Appropriations Act (CAA) 2021 created the first new allotment of Medicare-funded graduate medical education (GME) positions in approximately 25 years. ![]() The rapid expansion of advanced practice providers (APPs) in primary care has not been enough to bridge this ever-widening gap. The American Association of Medical Colleges (AAMC) now predicts a physician shortfall that could reach 139,000 by the year 2033, with severe shortages in primary care, a trend that could worsen due to effects of the COVID-19 pandemic on physician supply. While creating GME programs in a community health system may, at first glance, be perceived as cost-prohibitive, there are robust advantages to a system for their creation.Īt the time of the passage of the Patient Protection and Affordable Care Act (ACA), it was estimated that 34 million more patients need new primary care physicians, but the act provided no specific provisions to increase physician supply. Those trainees are the nucleus of succession planning for the current medical staff, can facilitate the creation and expansion of service lines, and may elevate the profile of the system through scholarly work and equity and quality improvement activities. Residents, fellows and medical students expand the capacity of the current healthcare workforce of a system by providing coverage during healthcare emergencies and staffing services in difficult-to-recruit specialties. The infrastructure needed to accredit GME programs may reduce the cost of care for both the patients and the system through improved patient outcomes and facilitation of system efforts to recognize and mitigate social determinants of health. This article provides a review of the evidence behind the value proposition for system administrators to foster the growth of GME in community health systems. The creation of new CMS-funded Graduate Medical Education (GME) cap positions by the Consolidated Appropriations Act 2021 offers a unique opportunity for systems in community and rural settings to develop and expand their training programs. ![]()
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