09 Jul NEJM Study Calculates Cost Of Training Residents in Teaching Health Centers

MedicalResearch.com Interview with:

Prof. Marsha Regenstein

Marsha Regenstein, Ph.D, Professor
From the Department of Health Policy and Management
Milken Institute School of Public Health
George Washington University
Washington, DC

MedicalResearch.com: What is the background for this study?

Response: Despite the billions of dollars in public spending on graduate medical education (GME) in the United States, little is known about the true cost of training a resident, with the few studies that exist showing wide variation in their methods and results. At the same time, the U.S. appears to be producing too few primary care physicians to meet the health care needs of the population, and especially those who live in underserved areas with high health care needs and shortages of health professionals. The Teaching Health Center (THC) Graduate Medical Education funding program was established under the Affordable Care Act to increase the number of medical and dental residents training in six primary care specialties in underserved areas. The Teaching Health Center funding supports community-based residency training in settings such as Federally-qualified health centers, rural clinics, mental health clinics and other non-profit community-based organizations. Hospitals commonly serve as training partners, but THC funding goes directly to the community-based partner, bringing funding and training closer to the communities where underserved patients live. The Health Resources and Services Administration (HRSA), which manages and funds the program, set an interim payment of $150,000 per resident; currently, 59 THCs are training 690 residents in 27 states and the District of Columbia. The interim payment rate was based on the best available information at the time and was meant to cover the full cost of training a resident.

MedicalResearch.com: What are the main findings?

Response: We were able to identify all relevant costs associated with residency training in a community-based setting; thus, our study provides a transparent approach to understanding the factors that drive residency expenses and revenues. This may serve as a useful model for future efforts to create more transparency in hospital-based GME funding.

MedicalResearch.com: What should readers take away from your report?

Response: The Teaching Health Centers are a relatively new model of training, with early signs indicating that the program is achieving an extremely national important goal of increasing the number of primary care residents in underserved communities. It will be important to monitor the costs of training residents over time to study their sustainability at current or future funding levels.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: The cost of residency training in any setting is complex but can be estimated with reasonable accuracy. This is important for planning the future of physician training and should be done on a national level –especially in regard to the public funds expended for residency training by the Medicare program.

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Citation:

The Cost of Residency Training in Teaching Health Centers
Marsha Regenstein, Ph.D., Kiki Nocella, Ph.D., M.H.A., Mariellen Malloy Jewers, M.I.A., and Fitzhugh Mullan, M.D.
June 29, 2016DOI: 10.1056/NEJMp1607866

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Last Updated on July 9, 2016 by Marie Benz MD FAAD