Who Pays to Train Tomorrow’s Pediatric Experts?
You may already know that All Children’s Hospital is a teaching hospital. Through our affiliation with the University of South Florida, we are the primary pediatric teaching hospital on Florida’s west coast. What you may not know is who pays for that training.
Once a physician graduates from medical school, he or she still faces several years of hands-on training called residency. These resident physicians (or residents) rotate through a variety of areas within hospitals and clinics under the direction of attending physicians, gaining experience in everything from emergency room care to outpatient office exams. Teaching hospitals pay attending physicians for the oversight and education they provide; they also pay residents for the care they give to patients.
Training: Adults Versus Kids…
When it comes to training the doctors who will deal with adults, teaching hospitals have historically received reimbursement through the federal Medicare program that covers senior citizens health care.
When it comes to doctors for kids, the job of teaching often falls to specialized pediatric hospitals. Independent children’s hospitals like All Children’s account for less than one percent of all hospitals nationwide. Yet they train nearly 30% of all pediatricians, half of all pediatric specialists and the majority of pediatric researchers.
These children’s hospitals are the perfect classrooms precisely because they treat only kids, not adults. But without adult patients, they don’t get Medicare dollars – or Medicare reimbursement for graduate medical education. Until recently, independent children’s hospitals were left to find the dollars on their own if they chose to incorporate teaching as part of their mission.
In 1999, with strong support from U.S. Representative C.W. “Bill” Young of St. Petersburg FL, Congress created the Children’s Hospitals Graduate Medical Education Program (CHGME). All Children’s Hospital is the only teaching hospital on Florida’s west coast that is eligible for CHGME funding, which amounted to approximately $3-million in 2005. The CHGME Program pays approximately 80% of what Medicare pays to adult teaching hospitals per resident in training.
Funding Not a Sure Thing….
But unlike Medicare funding for adult teaching hospitals, the CHGME program’s existence is not assured. CHGME is subject to regular reauthorization by Congress. Annual CHGME funding levels are also part of this Congressional review. As a result, All Children’s Hospital and 59 other CHGME-eligible institutions nationwide must regularly lobby our lawmakers in Washington to continue funding this program.