Whereas, The Physician Payment Review Commission notes that “direct costs of residents’ time spent in ambulatory sites and compensation for outpatient faculty are recognized only if the hospital ‘incurs all or substantially all’ of the costs of training”; and
Whereas, Post-Acute and Long-Term Care Medical Association (PALTmed) agrees with the PPRC’s observation that this “creates a disincentive for expanding training to group practices, nursing homes, and other non-traditional sites”; and
Whereas, PALTmed has suggested to the PPRC that in the development of proposals for extending coverage of direct graduate medical education costs for out-patient training, (Social Security Act, Title XVIII, Sec. 1886(h)) nursing homes should be included as a site of graduate medical residency training; and
Whereas, The Minimum Data Set/Resident Assessment Index (MDS/RAI) process used in nursing facilities may permit the creation of a more appropriate cost reimbursement system based upon the training site’s patient acuity mix rather than the patient-to-bed ratios used in hospitals; therefore be it
RESOLVED, that the American Medical Association, in conjunction with PALTmed, develop a proposal for evaluating methods to reimburse direct and indirect costs for physician training in non-traditional sites of Medicare services, and be it further
RESOLVED, The AMA work with PALTmed to assist the PPRC in research, consensus meetings or other activities directed at developing a methodology that will encourage the training of primary care physicians in non-traditional sites, including nursing homes.
Note: Effective August 13, 2024, AMDA - The Society for Post-Acute and Long-Term Care Medicine is now Post-Acute and Long-Term Care Medical Association (PALTmed).