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Starting New Osteopathic GME Programs
The AOA
• Professional Association Representing 64,000 Osteopathic Physicians & >15,600 Medical Students
• Primary Certifying Body for DOs• Accrediting Agency for Osteopathic
GME, Colleges of Osteopathic Medicine, Hospitals & Other Health Care Facilities
Osteopathic Medicine
• Founded in 1874 by Andrew Taylor Still, MD, DO
• Focused on the Whole Person- Unity of Mind, Body, Spirit- Structure Influences Function- Innate Ability of the Body to Health Itself
Osteopathic GME
• Primary Care Focus + 23 Medical Specialties
• Community-Based Clinical Education• 1 in 5 Medical Students attends 1 of
25 Colleges of Osteopathic Medicine in 28 Locations
• Osteopathic Medicine is One of the Fastest Growing Health Professions
OGME Development Initiative
A Ready Source of Information and Expert Assistance for Starting an Osteopathic
Graduate Medical Education Program in Your Hospital
Trends Affecting Hospitals
• Physician Workforce Shortages• New Colleges of Osteopathic Medicine
& Medical Schools• Increasing Number of Medical
Graduates• Increased Interest in Starting GME
Programs= New Hospital Opportunities
What Keeps CEOs Up at Night
• Competition for Well-Reimbursed Patient Services
• Increased Cost of Physician Services• Emphasis on Cost Containment• Quality Oversight/Ties to Payment• Shortage of Skilled Healthcare
Workers• Shortage of Physicians – Especially
Primary Care Physicians
Benefits of GME
• Hospital Benefits• Medical Staff Benefits• Recruiting Benefits• Patient Care Benefits• Bottom Line Benefits
Hospital Benefits
• Physician Recruitment• Culture of Education• In-House Physician Coverage• Educational & Technical Expertise• Enhanced Service to the Community• Competitive Advantage• Revenue Stream
Medical Staff Benefits
• Environment of Life-Long Learning• Expanded Referral Network• Prestige in the Community• Tighter Bonds Among Medical Staff &
Among Attendings, House Staff & Nursing
• Enhanced CME Opportunities• Succession Planning• Mentoring and Molding Future
Physicians
Recruiting Benefits
• Ability to “Grow Your Own” Medical Staff
• Reduced Physician Recruiting Expenses• Caliber of Training is a Known Quantity• Trainees are Already Known & At Home
in the Community• Interns & Residents Tend to Remain in
the Area Where They Train
Patient Care Benefits
• Access to Care• Enhanced Coverage & Quality• Enhanced Ability to Meet Community
Needs• Expanded Scope of Services• Presence of Residents 24/7• More Patient Contact with Physicians• Increased Comfort Level for Nursing• Opportunity for Clinical Trials &
Research
Bottom Line Benefits
• Medicare Direct & Indirect GME Payments• Reduced Medical Staff Coverage Expenses• Increase in Physician Referral Base• Financial Support also may be available
from Medicaid, the Veterans Administration and Other Federal or State Programs
A Word about Costs
Start-Up Costs Include:• Resident Salaries & Benefits• Faculty Salaries
- DME & Program Director(s) - Inpatient & Ambulatory Teaching Faculty- Support Staff
• Certain Capital & Equipment Costs (call rooms, library, computers, intern/resident lounge)
A Word about Payment
Medicare Pays Teaching Hospitals -
• Direct Graduate Medical Education (DGME) Payments
• Indirect Medical Education (IME) Adjustment
Based on Formulas, Statutory Factors
& Certain Hospital-Specific Data
DGME Payment
• Payment for Medicare’s Share of the Costs of Training Interns & Residents- Resident Salaries & Benefits- Faculty Compensation- Program Administration & Overhead Costs
• Calculated using Hospital-Specific Per Resident Amount, Medicare Utilization Rate & Number of Full Time Equivalent Residents
IME Adjustment
• Recognizes Teaching Hospitals Have Higher Patient Care Costs due to Presence of Trainees- Treating Sicker Patients- Offering More Services, Tests & Technology
• Calculated using Hospital-Specific Teaching Intensity (ratio of residents to beds), DRG Payments and Statutory IME Adjustment Factor for the Current Year
“New” Teaching Hospital
• Hospital with a GME Program Established On or After January 1, 1995
• Resident “Cap” is Set Based on the Number of Residents in All Specialty Programs in the Third Year After Training Begins
• Once Caps are Set, Urban Hospitals Generally Cannot Add Medicare-Funded Positions
• Rural Hospitals Can Add New Specialties but Cannot Expand Existing Programs
FTE Cap
• Hospital Can Train As Many Residents as it is Approved For
• Cap Establishes a Limit on the Number of Residents Medicare will Pay For
• Cap Necessitates Advance Planning & a Strategic Approach to Developing a GME Program
OGME Development Initiative
Marshalls the Resources of the AOA & the Osteopathic
Profession to Help Hospitals Interested in Starting New Osteopathic GME Programs
OGME Development Initiative
Employs –
• A Strategic Approach• Expert Consultants• Useful Materials on Starting and
Operating High Quality OGME Programs
OGME Development Initiative
Answers such Practical Questions as – • What are the Benefits of an OGME
Program?• What Assistance & Information are
Available?• How to Move Forward from Interest to
Program Approval?• Where to Call for Complimentary In-
Person Assistance from Experienced Consultants?
OGME Development Initiative
Provides Support to Assist You in – • Adding an OGME Program to Your
Hospital’s Strategic Plan• Reaping the Benefits of an OGME
Program- To the Hospital- To Patients- To the Community- To the Medical Staff
Strategic Framework
Helps You Determine How an OGME Program Fits with Your Hospital’s -
Strategic Framework
• Mission: Why Does the Hospital Exist?- Patient Care & Physician Services?- Service to the Community?- Quality & Safety?- Education?- Research?
Strategic Framework
• Vision: What Image does the
Hospital Want to Portray as it Works to Accomplish its Mission?
Strategic Framework
• Values: What Guiding Principles Drive the Hospital?- Moral Values?- Improving Community Health?- Providing Care for Those in Need?- Providing a Resource for Physicians?
SWOT Analysis
A Strategic Framework Helps You -
• Analyze How OGME Fits Into Your Hospital by Examining – - Internal Strengths- Internal Weaknesses- External Opportunities- External Threats
Knowledgeable Consultants
Initiative Corps of Consultants includes
• Seasoned Teaching Hospital CEOs & Senior Administrative Staff, Directors of Medical Education, Deans, Program Directors & Other Medical Educators
Knowledgeable Consultants
Provide Peer-to-Peer Assistance, by Conference Call & On Site, to -
• Answer Your Questions• Work One-on-One with Colleagues• Share their Expertise & Experience• Estimate Start-Up Costs & Medicare
Payment• Guide You Through the Accreditation
Process
Knowledgeable Consultants
Help You Identify the Keys to Success –
• Local Champions• Physician Leadership• Medical Staff • Hospital & System Administration• Hospital & System Boards• The Community• OPTIs
Knowledgeable Consultants
Focus on Critical Components - • Faculty Resources• Community Needs• Adequate Medicare Percentage for
Reasonable Payment• Sufficient Patient Load• Scope, Variety & Volume of Trainee
Experiences
Information & Materials
Provide You with Easy Access to Web-Based Resources on –
• Medicare Financing• Program Approval & Accreditation• Educational Standards & Policies• Physician, Hospital & Trainee Agreements• Templates, Models & Forms Designed to
Help Smooth Your Way to a Quality Program
