A bipartisan group of Senators on the Senate Finance Committee released a proposal to increase Medicare Graduate Medical Education (GME) slots. In addition to increasing GME funding, the proposal would better incentivize hospitals to train physicians in rural areas, create a council to improve the distribution of the added GME slots, and improve federal Medicare GME data collection and transparency.

While Congress has added 1,200 GME slots over the past four years, this proposal acknowledges more slots are needed to address physician shortages, particularly in rural areas. The proposal would add new Medicare GME slots from 2027 to 2031, with at least 25% going toward primary care residents and at least 15% toward psychiatry or psychiatry subspeciality residences.

This expansion would occur under a modified GME allocation formula to increase the number of slots in rural areas. To further this goal, the Senators would direct HHS to direct new GME slots to hospitals affiliated with a center of excellence, historically black colleges or universities (HBCUs), or minority-serving institutions (MSI) with the vision that these groups are more likely to work in rural and underserved communities in the long run.

The proposal creates a GME Policy Council of key stakeholders in medical education that would evaluate the distribution of the new GME slots and make recommendations to the HHS Secretary accordingly, especially in regard to allocation in rural areas and specific specialties.

Lastly, the proposal would improve data collection in response to concerns that the Medicare GME program lacks accountability. This provision would “require HHS to calculate Medicare GME slots per 100,000 residents by state and projected physician shortages by state and assess how Medicare GME investments address these projected shortages.” This additional data collected will be publicly available to increase transparency surrounding the program.

This policy proposal is an encouraging act by Congress to address the physician shortage impacting medical practices and hospitals across the country. However, increasing GME funding would have a steep price tag. The proposal does not identify a mechanism to offset this cost. The proposal has an unlikely path forward until Congress determines how to fund it.

ADVOCATE will share additional information with clients and friends as it becomes available on this and other Federal Health Policies.

Kirk Reinitz, President