Opening the "Black Box" of GME Costs and Benefits

A Conceptual Model and a Call for Systematic Studies

Published in: Journal of Graduate Medical Education, v. 7, no. 1, Commentary, Mar. 2015, p. 125-127

by Barbara O. Wynn

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At the heart of the current debate on financing graduate medical education (GME) is a seemingly simple question, how much does it cost hospitals and other health care providers to participate in GME? The answer has important implications for both the number and types of residency programs offered and the level of federal support needed to meet future physician workforce needs. Yet the question itself is not well understood, and information needed to answer it is lacking. Despite the importance that the net costs of operating individual residency training programs might have for the decisions sponsoring institutions make about operating these programs, the Institute of Medicine's (IOM) recent report, Graduate Medical Education That Meets the Nation's Health Care Needs, concludes that there is little understanding of the bottom-line financial impact of programs in various specialties, and that the costs and benefits of providing resident education are a "black box." As a step toward opening up this "black box," the IOM report recommended data collection and detailed reporting on the use of Medicare GME funds.

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