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Groups Involved in the GME Funding Discussion. JAMA. 1999;281(19):1856C. doi:10.1001/jama.281.19.1856
Prepared by Ashish Bajaj, Department of Resident and Fellow Services,
American Medical Association.
In the April 28 Resident Physician Forum, we reported on the
recommendations and actions of the National Bipartisan Commission on
the Future of Medicare. Two other governmental bodies, the Medicare
Payment Advisory Commission (MedPAC) and the Council on Graduate
Medical Education (COGME), are in the process of discussing Medicare
funding of graduate medical education (GME). To help residents
understand the framework of these discussions, we have summarized the
membership and purpose of these groups below.
Congress created MedPAC in the Balanced Budget Act of 1997 by combining
2 existing commissions: the Physician Payment Review Commission and the
Prospective Payment Assessment Commission. MedPAC is responsible for
reporting on all Medicare payment policies, including payments to
teaching hospitals for residency training. It is required to report to
MedPAC has collected testimony on GME funding and workforce issues,
including methods of GME funding, payment for teaching physicians and
allied health professionals, the role and funding of international
medical graduates, and specialty and geographic distribution of
physicians and residents. The next report on GME funding and workforce
planning is due in August.
MedPAC is a nonpartisan group with 17 members whose expertise
includes economics, health facility management, health plans and
integrated delivery systems, reimbursement, medical practice, and other
aspects of health services. Members were selected to also provide broad
geographic representation and a balance between urban and rural
representatives. Elderly recipients of Medicare benefits are also
represented. Transcripts of meetings, testimony, and reports are
available on MedPAC's Web site at www.medpac.gov.
Congress created COGME in 1986 and has authorized and funded the
group until 2002. COGME is charged with providing an ongoing assessment
of trends in the physician workforce, GME funding policies, and other
aspects of residency training. COGME also considers funding for
undergraduate medical education. It is required to make recommendations
to Congress and the US Department of Health and Human Services.
COGME also comprises 17 members, representing primary care physicians,
specialty societies, international medical graduates, medical student
and resident associations, medical and osteopathic schools, teaching
hospitals, health insurers, business, labor, the US Department of
Health and Human Services, and the Veterans Administration.
COGME has issued 14 reports on such topics as the
geographic and specialty distribution of physicians, managed care's
influence on GME, international medical graduates, and women and
minorities in medicine. Its reports include recommendations on federal
policy and actions by teaching hospitals and medical schools to address
future physician workforce needs. Reports and meeting information can
be found on their Web site at www.cogme.gov.
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