GME
also known as: Graduate Medical Education
Medicare's funding for residency training — pays teaching hospitals for the cost of training physicians.
Graduate Medical Education (GME) is the post-medical-school residency and fellowship training period during which physicians become licensed independent practitioners. Medicare is the largest single funder of GME nationally, paying teaching hospitals roughly $15B/yr.
GME funding has two parts:
- Direct GME (DGME) — pays hospitals for the direct costs of training (resident salaries, faculty time, administrative overhead)
- Indirect Medical Education (IME) — an adjustment to IPPS rates compensating teaching hospitals for the higher per-discharge costs they experience (more tests, more consults, longer LOS for similar cases)
GME residents are tracked on HCRIS Worksheet E-4. Hospital systems with large GME programs (Mass General Brigham, Cleveland Clinic, Mayo, NYP, Johns Hopkins, UPMC) get substantial annual Medicare payments through this mechanism — often $50M-$200M/yr in IME alone.
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