1. GME Finance and CHCs Kiki C. Nocella, PhD, MHA

2. Background and Experience Faculty at University of Southern California – Department of Family Medicine Founding Vice Provost of Health Affairs – University of California, Riverside Founder of Believe Health and KCN Consulting 2008-present Contracted with The George Washington University for the evaluation of THCs Have developed almost 100 residency programs and consortiums for states, regions, hospitals, and FQHCs.

3. Sources of Residency Funding Medicare GME Funding through the training hospital IME (added onto DRG) DGME (paid directly to hosp or CHC) State GME Funding Grants/Stipends from funders, medical schools Patient care revenue Institutional support (direct contribution and in-kind) HRSA THC-GME grants

4. Understanding a residency program’s finances Total Faculty Practice (ambulatory, not precepted) Resident Clinic (Precepted Ambulatory Visits) Resident Inpatient ServiceResidency N/A

5. Models of Relationships Hospital Sponsored CHC Sponsored CHC as Continuity Practice Rural Training Track (aka 1:2 program)

6. Considerations for CHCs planning residencies Cultures of service and education BPHC requirements and ACGME requirements Scope of services Relationships with hospitals Richness of education Exponential community value Improved P/L