New York state received nearly 20% of the nation’s graduate medical education (GME) funds, $2 billion of the $10 billion allocated in all by the federal government, while 29 other states each get less than 1%, a study reported.
New York alone has more residents than 31 other states combined. Meanwhile, Mississippi, the state with the lowest ratio of doctors to patients in the country, received just $22 million in federal payments, researchers said in a press release.
The researchers reviewed Medicare cost reports that list federal GME payments to teaching hospitals to draw their conclusions. Also of note:
• The number of Medicare-sponsored residents per 100,000 population was 1.63 in Montana versus 77.13 in New York;
• Total Medicare GME payments were $1.64 million in Wyoming;
• Payments per person was $1.94 in Montana versus $103.63 in New York; and
• Average payments per resident was $63,811 in Louisiana versus $155,135 in Connecticut.
Researchers at the George Washington University School of Public Health and Health Services reported their results in Health Affairs.
These imbalances will continue to promote an imbalance in physician availability across the country, the authors cautioned.
Medicare supports twice as many medical residents per person as the national average in three states, New York, Massachusetts and Rhode Island. Meanwhile, Montana, Idaho, Arkansas, Wyoming, Florida and California do not do well in terms of Medicare GME funding under the current system, according to the authors.
The researchers also found:
• New York has 77 Medicare-funded medical residents per 100,000 people while California has 19, Florida 14, and Arkansas has just 3.
• Florida, Texas and California have rapidly growing populations yet they received substantially less GME funding in 2010.
• The federal government pays Louisiana $64,000 per year to train each medical resident but gives Connecticut $155,000.
The authors wrote that a new GME payment formula is needed to stimulate the growth of residency training in parts of the country that are chronically underserved or are growing rapidly. Also, GME funding needs an oversight body that would adjust future funding.