Health Affairs Panel on IOM
GME report
Brad Poss, MD, MMM
Professor, Department of Pediatrics
Associate Dean for Graduate Medical Education
University of Utah School of Medicine
Medical Director, PICU
Primary Children’s Hospital
IOM GME Report (204 pages)
• Current GME funding:
– Not meeting physician workforce needs
– Non-transparent and outdated
– Does not reward innovation
– Lacks defined outcomes or metrics
IOM GME Recommendations
• Freeze GME funding at current levels
– Adjusted for inflation
• Create two governmental organizations
– CMS: Oversight of GME funding
– HHS: Policy and Planning
• One Medicare GME fund
– Operational Fund
– Transformation Fund
GME Public Funding
Panel 1: GME Governance and
Accountablity
• Gail Wilensky, Project Hope
– Co-chair of IOM report
• Tom Nasca, ACGME
– NAS, Milestones, CLER overview
• Steve Lipstein, BJC Healthcare
– History of past reviews set up of next panel
Panel 2-The GME Pipeline: Is it
Meeting Society’s Needs
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David Sklar, Academic Medicine
Stephen Shannon, AACOM
Edward Salsburg, GWU
Debra Weinstein, Partners Healthcare
System
Panel 3-Medicare Policy and
the Future of GME
• Atul Grover, AAMC
• Christopher Dawe, Dawe Health
Strategies
• Glen Hackbarth, Medicare Payment
Advisory Commitee
• Bruce Vladeck, Nexeria
AAMC Response to IOM Report
• Significant negative effects to proposed
teaching hospitals cuts
– Worsen physicians shortage as hospitals will
need to balance clinical and training demands
– Reduce access to care (burn units,
transplants, PICUs, trauma, etc) and clinical
trials
Local Opportunities
• Only academic medical center in a large
geographic region-natural experiment
– Potential for geographic redistribution
• Strengthen partnerships (VA, Intermountain,
others)
• Increased collaboration across programs, SOM,
HSC, and University
• VDO model for GME
– Pediatrics, Surgery, Radiology