Medical Groups Support Bid to Add 15,000 Residency Slots

Kerry Dooley Young

April 15, 2019

The Association of American Medical Colleges (AAMC) said more than 65 hospital and physician groups have joined it in a bid to increase Medicare funding for residency spots, especially in specialities for which shortages are predicted.

In a joint letter to US lawmakers, the organizations supported companion bills that make up the Resident Physician Shortage Act of 2019, which is pending in the House and Senate. The act would expand graduate medical education (GME) payments through Medicare for certain hospitals.

These measures would allow for an aggregate increase of 3000 positions per fiscal year for 5 years. The bill includes proposals meant to direct many of these residency slots toward specialties considered likely to face shortages.

"While we understand the many challenges Congress faces in the coming months, we stress the need to expand Medicare's support for physician training to ensure all Americans have access to the care they deserve," wrote the AAMC in an April 10 letter.

Demand for physicians continues to grow faster than supply. It is projected that by 2030, there will be a shortfall of between 42,600 and 121,300 physicians, with predicted shortages in both primary and specialty care, the groups said in the letter.

Cosigners of the letter include the Federation of American Hospitals, the Greater New York Hospital Association, and the Illinois Health and Hospital Association.

Physician specialty groups that signed the letter include the American Academy of Neurology, the American College of Cardiology, the American College of Obstetricians and Gynecologists, and the American College of Physicians.

Both the House and Senate bills were introduced by Democrats, Sen. Bob Menendez of New Jersey and Rep. Terri A. Sewell of Alabama. Sewell's bill has 14 Democratic cosponsors and four GOP cosponsors. The Republican cosponsors are from New York and Illinois.

In the Senate, Menendez' bill has two cosponsors, Minority Leader Charles E. Schumer (D-NY) and Sen. John Boozman (R-AR).

In a February 6 press release, Menendez said the Balanced Budget Act of 1997 created "an arbitrary cap" in the number of Medicare-funded GME positions.

In the same press release, Boozman (R-AR) called their proposal a "common sense bill." He said it would address a serious shortfall of physicians that hits his state's rural communities particularly hard.

"Lifting this antiquated cap on training slots for medical school graduates is a perfect example of a small reform that can make a big difference," Boozman said.

Medicare is the largest source of federal support for GME. Estimates of its fiscal 2015 payments range from about $10.3 billion to $12.5 billion, according to a December 2018 report from the Congressional Research Services. Federal decisions about Medicare's GME funding have a large effect on how physicians are trained and subsequently practice.

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