Starting New Osteopathic GME Programs. The AOA Professional Association Representing 64,000 Osteopathic Physicians & >15,600 Medical Students Primary.

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) 621-1773, ext. 8010

[email protected]