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

For Further Information OGME Development Initiative (800) , ext